Improvement of the anthropogenic emission rate estimate in Ulaanbaatar, Mongolia, for 2020-21 winter.

Ulaanbaatar (UB), the fast-growing capital of Mongolia, is known for its world's worst level of particulate matter (PM) concentrations in winter. However, current anthropogenic emission inventories over the UB are based on data from more than fifteen years ago, and satellite observations are scarce because UB is in high latitudes. During the winter of 2020-21, the first period of the Fine Particle Research Initiative in East Asia considering the National Differences (FRIEND), several times higher concentrations of PM in UB compared to other urban sites in East Asia were observed but not reproduced with a chemical transport model mainly due to the underestimated anthropogenic emissions. Therefore, we devised a method for sequentially adjusting emissions based on the reactivity of PM precursors using ground observations. We scaled emission rates for the inert species (CO, elemental carbon (EC), and organic carbon (OC)) to reproduce their observed ambient concentrations, followed by SO2 to reproduce the concentration of SO42-, which was examined to have the least uncertainty based on the abundance of observed NH3, and finally NO and NH3 for NO3-, and NH4+. This improved estimation is compared to regional inventories for Asia and suggests more than an order of magnitude increase in anthropogenic emissions in UB. Using the improved emission inventory, we were able to successfully reproduce independent observation data on PM2.5 concentrations in UB in December 2021 from the U.S. Embassy. During the campaign period, we found more than 50% of the SO42-, NO3-, and NH4+ increased in UB due to the improvement could travel to Beijing, China (BJ), and about 20% of the SO42- could travel to Noto, Japan (NT), more than 3000 km away. Also, the anthropogenic emissions in UB can effectively increase OC, NO3-, and NH4+ concentrations in BJ when Gobi dust storms occur.

North Korean CO emissions reconstruction using DMZ ground observations, TROPOMI space-borne data, and the CMAQ air quality model.

Emission uncertainty in North Korea can act as an obstacle when developing air pollution management plans in the country and neighboring countries when the transboundary transport of air pollutants is considered. This study introduces a novel approach for adjusting and reallocating North Korean CO emissions, aiming to complement the limited observational and emissions data on the country's air pollutants. We utilized ground observations from demilitarized zone (DMZ) and vertical column density (VCD) data from a TROPOspheric Monitoring Instrument (TROPOMI), which were combined with the Community Multi-Scale Air Quality (CMAQ) chemistry transport model simulations. The Clean Air Support System (CAPSS) and Satellite Integrated Joint Monitoring of Air Quality (SIJAQ) emissions inventories served as the basis for our initial simulations. A two-step procedure was proposed to adjust both the emission intensity and the spatial distribution of emissions. First, air quality simulations were conducted to explore model sensitivity to changes in North Korean CO emissions with respect to ground concentrations. DMZ observations then constrained these simulations to estimate corresponding emission intensity. Second, the spatial structure of North Korean CO emission sources was reconstructed with the help of TROPOMI CO VCD distributions. Our two-step hybrid method outperformed individual emissions adjustment and spatial reallocation based solely on surface or satellite observations. Validation using ground observations from the Chinese Dandong site near the China-North Korea border revealed significantly improved model simulations when applying the updated CO emissions. The adjusted CO emissions were 10.9 times higher than those derived from the bottom-up emissions used in this study, highlighting the lack of information on North Korean pollutants and emission sources. This approach offers an efficient and practical solution for identifying potential missing emission sources when there is limited on-site information about air quality on emissions.

When and why PM2.5 is high in Seoul, South Korea: Interpreting long-term (2015-2021) ground observations using machine learning and a chemical transport model.

Seoul has high PM2.5 concentrations and has not attained the national annual average standard so far. To understand the reasons, we analyzed long-term (2015-2021) hourly observations of aerosols (PM2.5, NO3-, NH4+, SO42-, OC, and EC) and gases (CO, NO2, and SO2) from Seoul and Baekryeong Island, a background site in the upwind region of Seoul. We applied the weather normalization method for meteorological conditions and a 3-dimensional chemical transport model, GEOS-Chem, to identify the effect of policy implementation and aerosol formation mechanisms. The monthly mean PM2.5 ranges between about 20 µg m-3 (warm season) and about 40 µg m-3 (cold season) at both sites, but the annual decreasing rates were larger at Seoul than at Baengnyeong (-0.7 µg m-3 a-1 vs. -1.8 µg m-3 a-1) demonstrating the effectiveness of the local air quality policies including the Special Act on Air Quality in the Seoul Metropolitan Area (SAAQ-SMA) and the seasonal control measures. The weather-normalized monthly mean data shows the highest PM2.5 concentration in March and the lowest concentration in August throughout the 7 years with NO3- accounting for about 40 % of the difference between the two months at both sites. Taking together with the GEOS-Chem model results, which reproduced the elevated NO3- in March, we concluded the elevated atmospheric oxidant level increases in HNO3 (which is not available from the observation) and the still low temperatures in March promote rapid production of NO3-. We used Ox (≡ O3 + NO2) from the observation and OH from the GEOS-Chem as a proxy for the atmospheric oxidant level which can be a source of uncertainty. Thus, direct observations of OH and HNO3 are needed to provide convincing evidence. This study shows that reducing HNO3 levels through atmospheric oxidant level control in the cold season can be effective in PM2.5 mitigation in Seoul.

Impact of ozonation on the formation of particulate nitrosodi-methylamine (NDMA) in atmosphere.

The contribution of ozonation to the formation of particulate nitrosodi-methylamine (NDMA) in the aqueous aerosol phase was investigated using measurement data from 2018 in Seoul, Republic of Korea and a box model. The correlation between the NDMA concentration and aerosol liquid water content and box model results showed that aqueous aerosol phase reactions, including nitrosation and ozonation, might contribute to the formation of NDMA. The concentration of NDMA and the ratio of O3/dimethylamine exhibited a negative correlation, suggesting that the contribution of ozonation to NDMA formation may not be significant. Furthermore, when the daily concentration of NDMA exceeded 10 ng/m3, the pH was 3.96 ± 0.48, indicating that the impact of ozonation on NDMA concentration might not be significant. To quantitatively investigate the contribution of ozonation, the ozonation mechanism that forms NDMA was included in the box model developed in our previous study. The model results showed that the ozonation contributed to the ambient concentration of NDMA (7.9 ± 3.8% (winter); 1.9 ± 3.0% (spring); 10.0 ± 0.77% (summer); 3.6 ± 7.3% (autumn)). It is estimated that the relatively higher O3/NOx ratio in summer (1.63 ± 0.69; 0.64 ± 0.52 (winter); 1.14 ± 0.92 (spring); 0.52 ± 0.54 (autumn)) could enhance ozonation and that relatively lower pH in summer (2.2 ± 0.4; 5.3 ± 1.2 (winter); 3.9 ± 1.2 (spring); 3.9 ± 0.7 (autumn)) could hinder nitrosation compared to that in other seasons.

Parameterization of below-cloud scavenging for polydisperse fine mode aerosols as a function of rain intensity.

The below-cloud aerosol scavenging process by precipitation is one of the most important mechanisms to remove aerosols from the atmosphere. Due to its complexity and dependence on both aerosol and raindrop sizes, wet scavenging process has been poorly treated, especially during the removal of fine particles. This makes the numerical simulation of below-cloud scavenging in large-scale aerosol models unrealistic. To consider the slip effects of submicron particles, a simplified expression for the diffusion scavenging was developed by approximating the Cunningham slip correction factor. The derived analytic solution was parameterized as a simple power function of rain intensity under the assumption of the lognormal size distribution of particles. The resultant approximated expression was compared to the observed data and the results of previous studies including a 3D atmospheric chemical transport model simulation. Compared with the default GEOS-Chem coefficient of 0.00106R0.61 and the observation-based coefficient of 0.0144R0.9268, the coefficient of a and b in Λm = aRb spread in the range of 0.0002- 0.1959 for a and 0.3261- 0.525 for b over a size distribution of GSD of 1.3-2.5 and a geometric mean diameter of 0.01- 2.5 µm. Overall, this study showed that the scavenging coefficient varies widely by orders of magnitude according to the size distribution of particles and rain intensity. This study also demonstrated that the obtained simplified expression could consider the theoretical approach of aerosol polydispersity. Our proposed analytic approach showed that results can be effectively applied for reduced computational burden in atmospheric modeling.

Effects of Top and Bottom Electrodes Materials and Operating Ambiance on the Characteristics of MgFx Based Bipolar RRAMs.

The effects of electrode materials (top and bottom) and the operating ambiances (open-air and vacuum) on the MgFx-based resistive random-access memory (RRAM) devices are studied. Experiment results show that the device's performance and stability depend on the difference between the top and bottom electrodes' work functions. Devices are robust in both environments if the work function difference between the bottom and top electrodes is greater than or equal to 0.70 eV. The operating environment-independent device performance depends on the surface roughness of the bottom electrode materials. Reducing the bottom electrodes' surface roughness will reduce moisture absorption, minimizing the impact of the operating environment. Ti/MgFx/p+-Si memory devices with the minimum surface roughness of the p+-Si bottom electrode show operating environment-independent electroforming-free stable resistive switching properties. The stable memory devices show promising data retentions of >104 s in both environments with DC endurance properties of more than 100 cycles.

Long-term trends and affecting factors in the concentrations of criteria air pollutants in South Korea.

Here, we used a novel approach to analyze the trends in the concentrations of six national criteria air pollutants, carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), PM10, PM2.5, and surface ozone (O3), between 2001 and 2018, and the factors affecting the concentrations of CO and SO2 at the district level in South Korea (Korea) between 2011 and 2016. We considered four factors affecting the concentrations of CO and SO2: (1) concentration-to-emission ratio, (2) air pollutant-to-CO2 emission ratio, (3) carbon intensity, and (4) area-weighted energy supply. We found that the most influencing factors determining the concentrations of CO and SO2 in Korea were the air pollutant-to-CO2 emission ratio and the concentration-to-emission ratio. The annual mean concentrations of CO, SO2, PM10, PM2.5, and NO2 generally decreased, while O3 levels showed an increasing trend, over the last 18 years in Korea. We also found that NO2 concentration had strong positive and negative correlations with PM2.5 and O3 concentrations, respectively. However, the relationship between O3 and NO2 levels showed an inverted U shape under NO2 super-rich condition (e.g., > 55 ppb in Seoul), and the daily maximum 8-h values (MDA8O3) increased in proportion to the NO2 level under poor NO2 conditions (e.g., < 25 ppb in Seoul).

Contribution of liquid water content enhancing aqueous phase reaction forming ambient particulate nitrosamines.

Contribution of liquid water content (LWC) to the levels of the carcinogenic particulate nitro(so) compounds and the chemistry affecting LWC were investigated based on the observation of seven nitrosamines and two nitramines in rural (Seosan) and urban (Seoul) area in South Korea during October 2019 and a model simulation. The concentrations of both the total nitrosamines and nitramines were higher in Seosan (12.48 ± 16.12 ng/m3 and 0.65 ± 0.71 ng/m3, respectively) than Seoul (7.41 ± 13.59 ng/m3 and 0.24 ± 0.15 ng/m3, respectively). The estimated LWC using a thermodynamic model in Seosan (12.92 ± 9.77 µg/m3) was higher than that in Seoul (6.20 ± 5.35 µg/m3) mainly due to higher relative humidity (75 ± 9% (Seosan); 62 ± 10% (Seoul)) and higher concentrations of free ammonia (0.13 ± 0.09 µmol/m3 (Seosan); 0.08 ± 0.01 µmol/m3 (Seoul)) and total nitric acid (0.09 ± 0.07 µmol/m3 (Seosan); 0.04 ± 0.02 µmol/m3 (Seoul)) in Seosan while neither fog nor rain occurred during the sampling period. The relatively high concentrations of the particulate nitrosamines (>30 ng/m3) only observed probably due to the higher LWC (>10 µg/m3) in Seosan. It implies that aqueous phase reactions involving NO2 and/or uptake from the gas phase enhanced by LWC could be promoted in Seosan. Strong correlation between the concentrations of nitrosodi-methylamine (NDMA), an example of nitrosamines, simulated by a kinetic box model including the aqueous phase reactions and the measured concentration of NDMA in Seosan (R = 0.77; 0.37 (Seoul)) indicates that the aqueous phase reactions dominantly enhanced the NDMA concentrations in Seosan. On the other hand, it is estimated that the formation of nitrosamines by aqueous phase reaction was not significant due to the relatively lower LWC in Seoul compared to that in Seosan. Furthermore, it is presumed that nitramines are mostly emitted from the primary emission sources. This study implies that the concentration of the particulate nitrosamines can be promoted by aqueous phase reaction enhanced by LWC.

The Korea-United States Air Quality (KORUS-AQ) field study.

The Korea-United States Air Quality (KORUS-AQ) field study was conducted during May-June 2016. The effort was jointly sponsored by the National Institute of Environmental Research of South Korea and the National Aeronautics and Space Administration of the United States. KORUS-AQ offered an unprecedented, multi-perspective view of air quality conditions in South Korea by employing observations from three aircraft, an extensive ground-based network, and three ships along with an array of air quality forecast models. Information gathered during the study is contributing to an improved understanding of the factors controlling air quality in South Korea. The study also provided a valuable test bed for future air quality-observing strategies involving geostationary satellite instruments being launched by both countries to examine air quality throughout the day over Asia and North America. This article presents details on the KORUS-AQ observational assets, study execution, data products, and air quality conditions observed during the study. High-level findings from companion papers in this special issue are also summarized and discussed in relation to the factors controlling fine particle and ozone pollution, current emissions and source apportionment, and expectations for the role of satellite observations in the future. Resulting policy recommendations and advice regarding plans going forward are summarized. These results provide an important update to early feedback previously provided in a Rapid Science Synthesis Report produced for South Korean policy makers in 2017 and form the basis for the Final Science Synthesis Report delivered in 2020.

Disentangling the contribution of the transboundary out-flow from the Asian continent to Tokyo, Japan.

We assessed the contribution of transboundary air pollutants (TAPs) transported from China to Tokyo using the Pb(0.5

Particulate Nitrosamines and Nitramines in Seoul and Their Major Sources: Primary Emission versus Secondary Formation.

Seven nitrosamines and three nitramines in particulate matter with an aerodynamic diameter of less than or equal to 2.5 µm (PM2.5) collected in 2018 in Seoul, South Korea, were quantified. Annual mean concentrations of the sum of nitrosamines and nitramines were 9.81 ± 18.51 and 1.12 ± 0.70 ng/m3, respectively, and nitrosodi-methylamine (NDMA) and dimethyl-nitramine (DMN) comprised the largest portion of nitrosamines and nitramines, respectively. Statistical analyses such as non-parametric correlation analysis, positive matrix factorization, analysis of covariance, and orthogonal partial least squared discrimination analysis were carried out to identify contribution of the atmospheric reactions in producing NDMA and DMN. In addition, kinetic calculation using reaction information obtained from the previous chamber studies was performed to estimate concentrations of NDMA and DMN that might be produced from the atmospheric reactions. It was concluded that (1) the atmospheric reactions contributed to the concentrations of NDMA more than they did for those of DMN, (2) the contribution of atmospheric reactions to the concentrations of NDMA and DMN was significant due to high NO2 concentrations in winter, and (3) primary emissions predominantly affected the ambient concentrations of NDMA and DMN in spring, summer, and autumn.

Trace Level Determination of Saccharides in Pristine Marine Aerosols by Gas Chromatography-Tandem Mass Spectrometry.

The quantification and identification of saccharides in pristine marine aerosols can provide useful information for determining the contributions of anthropogenic and natural sources of the aerosol. However, individual saccharide compounds in pristine marine aerosols that exist in trace amounts are difficult to analyze due to their low concentrations. Thus, in this study, we applied gas chromatography-tandem mass spectrometry (GC-MS/MS) in multiple reaction monitoring (MRM) mode to analyze the particulate matter with an aerodynamic diameter equal or less than 2.5 µm (PM2.5) samples, and the results were compared with those of conventional GC-MS. To investigate the chemical properties of pristine marine aerosols, 12 PM2.5 samples were collected while aboard Araon, an ice-breaking research vessel (IBRV), as it sailed from Incheon, South Korea to Antarctica. The method detection limits of GC-MS/MS for 10 saccharides were 2-22-fold lower than those of GC-MS. Consequently, the advantages of GC-MS/MS include (1) more distinct peak separations, enabling the accurate identification of the target saccharides and (2) the quantification of all individual saccharide compounds with concentrations outside the quantifiable range of GC-MS. Accordingly, the time resolution for sampling saccharides in pristine marine aerosols can be improved with GC-MS/MS.

Determination of atmospheric amines at Seoul, South Korea via gas chromatography/tandem mass spectrometry.

Due to their important roles in salt-producing acid-base reactions, new particle formation (NPF), and as precursors in secondary organic aerosol (SOA) producing reactions, the atmospheric concentrations of particulate volatile amines (dimethylamine (DMA), ethylamine, diethylamine (DEA), propylamine, and butylamine) at Seoul were analyzed and evaluated. To quantify the presence of volatile amines in particulate matter with aerodynamic diameters less than or equal to a nominal 2.5 µm (PM2.5), an efficient and rapid analytical method based on in-matrix ethyl chloroformate (ECF) derivatization followed by headspace solid-phase microextraction (HS-SPME) was developed and validated using gas chromatography coupled with tandem mass spectrometry (GC-MS/MS) in the multiple reaction monitoring (MRM) mode. The annual mean concentration of the total 5 target amines was 5.56±2.76 ng/m3 and the seasonal difference was small. The concentrations of particulate amines measured in this study were lower than those observed in Zongludak, Turkey, Nanjing, China, and Jeju, Korea but slightly higher than that reported in Kobe, Japan. The concentrations of the nitrosamines (nitrosodimethylamine (NDMA) and nitrosodiethylamine (NDEA)), and of the nitramines (dimethylnitramine (DMN) and diethylnitramine (DEN)) measured along with those of the target amines were used in a simple linear regression analysis. It indicates the contribution of DMA to the formation of NDMA in all seasons (except the fall) and DEA to the formation of NDEA in the summer, while DMA and DEA did not significantly contribute to the formation of nitramines.

Recent Occurrence of PAHs and n-Alkanes in PM2.5 in Seoul, Korea and Characteristics of their Sources and Toxicity.

Polycyclic Aromatic Hydrocarbons (PAHs) and n-alkanes in particulate matter with an aerodynamic diameter of 2.5 micrometers or less (PM2.5) were quantified at Seoul, Korea in 2018. The seasonal differences in the total concentration of PAHs and n-Alkanes were clear, where winter showed a higher concentration than that of summer. Compared to the PAHs measurements in 2002 at Seoul, the sum of PAHs concentrations in 2018 were reduced from 26.6 to 5.6 ng m-3. Major sources of the observed PAHs and n-alkanes were deduced from various indicators such as diagnostic ratios for PAHs and Cmax, CPI, and WNA (%) indices for n-alkanes. It was found that in winter coal and biomass combustions, and vehicular exhaust were major sources, while, in summer vehicular exhaust was major source. In addition, in winter, major emission sources were located outside of Seoul. The health effect from the recent level of PAHs was estimated and compared to the previous studies observed in Seoul, and it was found that, recently, the toxicity of PAHs in PM2.5 was significantly decreased, except for in the winter.

Seasonal and annual changes in PAH concentrations in a remote site in the Pacific Ocean.

This paper reports the long term observation of particle-associated polycyclic aromatic hydrocarbons (PAHs) at Cape Hedo Atmosphere and Aerosol Monitoring Station, a remote site in the Western Pacific Ocean, from 2008 to 2015. This is the first long-term study that evaluated the contribution of long-range transport of PAHs in East Asia. No obvious trend (P > 0.05) was found in a particular season over the years. However, there are seasonal variations of PAH concentrations with higher in spring and winter. The higher PAH are attributed to air masses from the area including part of China. Source apportionment using three different approaches, i.e., PAH compositional pattern analysis, PAH diagnostic ratio analysis and positive matrix factorization modeling, showed the combined high contribution of biomass burning (18%, 14%) and coal combustion (33%, 24%) in spring and winter. In addition, the contribution of ship emissions (35%) was relatively high in spring, whereas that of vehicle emissions (36%) was relatively high in winter. The contribution of coal combustion to PAH has decreased throughout the years, likely due to changes in energy structure in China. The contribution of biomass burning to PAH has showed no trend, being stable, and that of vehicular emissions has increased.

Analysis of Polycyclic Aromatic Hydrocarbons in Ambient Aerosols by Using One-Dimensional and Comprehensive Two-Dimensional Gas Chromatography Combined with Mass Spectrometric Method: A Comparative Study.

Advanced separation technology paired with mass spectrometry is an ideal method for the analysis of atmospheric samples having complex chemical compositions. Due to the huge variety of both natural and anthropogenic sources of organic compounds, simultaneous quantification and identification of organic compounds in aerosol samples represents a demanding analytical challenge. In this regard, comprehensive two-dimensional gas chromatography with time-of-flight mass spectrometry (GC×GC-TOFMS) has become an effective analytical method. However, verification and validation approaches to quantify these analytes have not been critically evaluated. We compared the performance of gas chromatography with quadrupole mass spectrometry (GC-qMS) and GC×GC-TOFMS for quantitative analysis of eighteen target polycyclic aromatic hydrocarbons (PAHs). The quantitative obtained results such as limits of detection (LODs), limits of quantification (LOQs), and recoveries of target PAHs were approximately equivalent based on both analytical methods. Furthermore, a larger number of analytes were consistently identified from the aerosol samples by GC×GC-TOFMS compared to GC-qMS. Our findings suggest that GC×GC-TOFMS would be widely applicable to the atmospheric and related sciences with simultaneous target and nontarget analysis in a single run.

Development and Validation of Gas Chromatography-Triple Quadrupole Mass Spectrometric Method for Quantitative Determination of Regulated Plasticizers in Medical Infusion Sets.

A method for the quantitative determination of dibutyl phthalate (DBP), benzyl butyl phthalate (BBP), bis(2-ethylhexyl) adipate (DEHA), bis(2-ethylhexyl) phthalate (DEHP), di-n-octyl phthalate (DNOP), dioctyl terephthalate (DOTP), diisononyl phthalate (DINP), and diisodecyl phthalate (DIDP) in medical infusion sets was developed and validated using gas chromatography coupled with triple quadrupole mass spectrometry (GC-MS/MS) in the multiple reaction monitoring (MRM) mode. Solvent extraction with polymer dissolution for sample preparation was employed prior to GC-MS/MS analysis. Average recoveries of the eight target analytes are typically in the range of 91.8-122% with the relative standard deviations of 1.8-17.8%. The limits of quantification (LOQs) of the analytical method were in the ranges of 54.1 to 76.3 ng/g. Analysis using GC-MS/MS provided reliable performance, as well as higher sensitivity and selectivity than GC-MS analysis, especially for the presence of minority plasticizers at different concentrations.

Optimization of Split-Bolus CT Urography: Effect of Differences in Allocation of Contrast Medium and Prolongation of Imaging Delay.

OBJECTIVE: The purpose of this study was to find the optimal allocation ratio of contrast medium (CM) in split-bolus CT urography (CTU) and to investigate the effect of increased imaging delays for synchronous nephrographic-excretory phase imaging. SUBJECTS AND METHODS: One hundred ninety-two patients were randomly assigned to one of three protocols with different allocation ratios of CM: group A, 30% of CM at first bolus and 70% of CM at second bolus; group B, 70% and 30%; or group C, 50% and 50%. Saline (250 mL) was administered after the first CM bolus. Patients were subdivided by different imaging delay times (8, 10, 12, and 14 minutes). The attenuation values of the renal cortex and medulla were measured, and the opacification and maximal caliber of each segment of the ureter were evaluated. RESULTS: Renal cortical enhancement was significantly higher in group A (mean ± SD, 145.9 ± 17.5 HU) than group B (120.6 ± 106.3 HU). No significant difference in renal parenchymal enhancement was found with increased imaging delay times. The opacification and maximal caliber of each ureter segment showed no significant difference with different allocation ratios of CM or increased imaging delay times. CONCLUSION: A split-bolus CTU protocol with a larger CM volume administered at the second injection and an 8-minute imaging delay was the optimal protocol with regard to opacification of the ureter, renal parenchymal enhancement, and shorter examination time.

Effectiveness of Ambulatory Tru-Close Thoracic Vent for the Outpatient Management of Pneumothorax: A Prospective Pilot Study.

OBJECTIVE: This study aimed to assess the technical feasibility, procedural safety, and long-term therapeutic efficacy of a small-sized ambulatory thoracic vent (TV) device for the treatment of pneumothorax. MATERIALS AND METHODS: From November 2012 to July 2013, 18 consecutive patients (3 females, 15 males) aged 16-64 years (mean: 34.7 ± 14.9 years, median: 29 years) were enrolled prospectively. Of these, 15 patients had spontaneous pneumothorax and 3 had iatrogenic pneumothorax. A Tru-Close TV with a small-bore (11- or 13-Fr) catheter was inserted under bi-plane fluoroscopic assistance. RESULTS: Technical success was achieved in all patients. Complete lung re-expansion was achieved at 24 hours in 88.9% of patients (16/18 patients). All patients tolerated the procedure and no major complications occurred. The patients' mean numeric pain intensity score was 2.4 (range: 0-5) in daily life activity during the TV treatment. All patients with spontaneous pneumothorax underwent outpatient follow-up. The mean time to TV removal was 4.7 (3-13) days. Early surgical conversion rate of 16.7% (3/18 patients) occurred in 2 patients with incomplete lung expansion and 1 patient with immediate pneumothorax recurrence post-TV removal; and late surgical conversion occurred in 2 of 18 patients (11.1%). The recurrence-free long-term success rate was 72.2% (13/18 patients) during a 3-year follow-up period from November 2012 to June 2016. CONCLUSION: TV application was a simple, safe, and technically feasible procedure in an outpatient clinic, with an acceptable long-term recurrence-free rate. Thus, TV could be useful for the immediate treatment of pneumothorax.

Optimized Performance of FlightPlan during Chemoembolization for Hepatocellular Carcinoma: Importance of the Proportion of Segmented Tumor Area.

OBJECTIVE: To evaluate retrospectively the clinical effectiveness of FlightPlan for Liver (FPFL), an automated tumor-feeding artery detection software in cone-beam CT angiography (CBCTA), in identifying tumor-feeding arteries for the treatment of hepatocellular carcinoma (HCC) using three different segmentation sensitivities. MATERIALS AND METHODS: The study included 50 patients with 80 HCC nodules who received transarterial chemoembolization. Standard digital subtracted angiography (DSA) and CBCTA were systematically performed and analyzed. Three settings of the FPFL software for vascular tree segmentation were tested for each tumor: the default, Group D; adjusting the proportion of segmented tumor area between 30 to 50%, Group L; and between 50 to 80%, Group H. RESULTS: In total, 109 feeder vessels supplying 80 HCC nodules were identified. The negative predictive value of DSA, FPFL in groups D, L, and H was 56.8%, 87.7%, 94.2%, 98.5%, respectively. The accuracy of DSA, FPFL in groups D, L, and H was 62.6%, 86.8%, 93.4%, 95.6%, respectively. The sensitivity, negative predictive value (NPV), and accuracy of FPFL were higher in Group H than in Group D (p = 0.041, 0.034, 0.005). All three segmentation sensitivity groups showed higher specificity, positive predictive value, NPV, and accuracy of FPFL, as compared to DSA. CONCLUSION: FlightPlan for Liver is a valuable tool for increasing detection of HCC tumor feeding vessels, as compared to standard DSA analysis, particularly in small HCC. Manual adjustment of segmentation sensitivity improves the accuracy of FPFL.