Although acute exacerbations of idiopathic pulmonary fibrosis are well recognised, there are no studies documenting their prevalence or identifying pre-existing risk factors.This study analysed the clinical, radiological and pathological data of 11 patients who satisfied the criteria for acute exacerbation among 147 patients with biopsy-proven idiopathic pulmonary fibrosis. There were five additional patients who had similar demographics, radiology and surgical lung biopsy pathology, but had clinically less severe disease, and so were not included. The 2-yr frequency of acute exacerbation was 9.6% after the diagnosis. Most exacerbations were idiopathic, although two cases presented after surgical lung biopsy and one after bronchoalveolar lavage.No significant risk factor was found by univariate proportional hazard analysis. Imaging revealed diffuse bilateral ground-glass opacification superimposed on subpleural reticular and honeycombing densities. The biopsies of four patients taken during acute exacerbation exhibited diffuse alveolar damage superimposed upon usual interstitial pneumonia.The findings of this study demonstrate that acute exacerbation of idiopathic pulmonary fibrosis is rather common and this exacerbation is likely to have a spectrum of severity.

Abstract. The 1883 Krakatau volcanic eruption has generated a destructive tsunami higher than 40 m on the Indonesian coast where more than 36 000 lives were lost. Sea level oscillations related with this event have been reported on significant distances from the source in the Indian, Atlantic and Pacific Oceans. Evidence of many manifestations of the Krakatau tsunami was a subject of the intense discussion, and it was suggested that some of them are not related with the direct propagation of the tsunami waves from the Krakatau volcanic eruption. Present paper analyzes the hydrodynamic part of the Krakatau event in details. The worldwide propagation of the tsunami waves generated by the Krakatau volcanic eruption is studied numerically using two conventional models: ray tracing method and two-dimensional linear shallow-water model. The results of the numerical simulations are compared with available data of the tsunami registration.

Purpose Incisional hernia is a complication following abdominal operation. Patients undergoing liver transplantation have a high risk of developing incisional hernia because of immunosuppression. The purpose of this study was to evaluate incisional hernia after liver transplantation and to identify risk factors for hernia formation in those patients. Methods We retrospectively reviewed 1044 adult patients with more than 2 years of follow-up in patients who underwent liver transplantation from January 2000 to December 2015. Results Incisional hernia was identified in 79 patients with more than 2 years of follow-up. The overall incisional hernia rate was 7.6%. The mean age and body mass index (BMI) of the patients with incisional hernia were 55 ± 9 years and 25.3 ± 3.7 kg/m 2 , respectively. No significant differences in gender, diagnosis, diabetes, Child-Pugh score, model for endstage liver disease (MELD) score, donor type, hepatorenal syndrome, varix bleeding, ascites, hepatic encephalopathy, ventilator use, spontaneous bacterial peritonitis (SBP), or bile leakage were found between patients who did and did not develop incisional hernia. Patients with acute rejection before hernia development were more to have herniated patients hernia (p < 0.05). Conclusion Age greater than 55 years and high BMI were significant risk factors. We identified risk factors for the development of incisional hernia. Based on these risk factors, attention should be paid to incisional hernia in older and obese patients.

S E T T I N G : Eleven referring hospitals in South Korea. O B J E C T I V E :To compare therapeutic responses in chronic obstructive pulmonary disease (COPD) subgroups, classifi ed by diffusing capacity of the lung for carbon monoxide (DL CO ) and lung volume. D E S I G N : A total of 130 stable male COPD patients were classifi ed into four subgroups according to baseline DL CO and residual volume/total lung capacity (RV/TLC) ratio. We compared therapeutic responses to short acting β 2 -agonist (SABA) and 3-month combined inhalation of long-acting β 2 -agonist (LABA) and corticosteroid among patients with these subgroups. CHRONIC obstructive pulmonary disease (COPD) is characterised by chronic airfl ow limitation that is not fully reversible. 1 COPD is not a single disease but rather a group of conditions with variable clinical, physiological and radiographic manifestations. 2 S U M M A R YThe Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend different treatment strategies based on the severity of airfl ow limitation, as assessed by post-bronchodilator forced expiratory volume in 1 second (FEV 1 ) values. 1 Although FEV 1 is useful in the diagnosis and physiological staging of COPD, arbitrary stratifi cations of SDL and YMO contributed equally to this article.