ABSTRACT:In this study, spatial and temporal patterns of changes in extreme events of temperature and precipitation at 143 weather stations in ten Asia-Pacific Network (APN) countries and their associations with changes in climate means are examined for the 1955-2007 period. Averaged over the APN region, annual frequency of cool nights (days) has decreased by 6.4 days/decade (3.3 days/decade), whereas the frequency of warm nights (days) has increased by 5.4 days/decade (3.9 days/decade). The change rates in the annual frequency of warm nights (days) over the last 20 years (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) have exceeded those over the full 1955-2007 period by a factor of 1.8 (3.4). Seasonally, the frequencies of summer warm nights and days are changing more rapidly per unit change in mean temperatures than the corresponding frequencies for cool nights and days. However, normalization of the extreme and mean series shows that the rate of changes in extreme temperature events are generally less than that of mean temperatures, except for winter cold nights which are changing as rapidly as the winter mean minimum temperature. These results indicate that there have been seasonally and diurnally asymmetric changes in extreme temperature events relative to recent increases in temperature means in the APN region.There are no systematic, regional trends over the study period in total precipitation, or in the frequency and duration of extreme precipitation events. Statistically significant trends in extreme precipitation events are observed at fewer than 30% of all weather stations, with no spatially coherent pattern of change, whereas statistically significant changes in extreme temperature events have occurred at more than 70% of all weather stations, forming strongly coherent spatial patterns.

Spatial and temporal patterns in the onset, offset, and length of the snow season across Northern Hemisphere continents are examined for the period from 1967 to 2008. Full snow seasons (FSS) and core snow seasons (CSS) are defined based on the consistency of snow cover within a location over the course of the cold season. Climatologically, the seasonal onsets of FSS and CSS progress more rapidly across the continents than the slower spring northward offset. Average Northern Hemisphere FSS duration has decreased at a rate of 0.8 week decade−1 (5.3 days decade−1) between the winters of 1972/73 and 2007/08, while there is no significant hemispheric change in CSS duration. Changes in the FSS duration are attributed primarily to a progressively earlier offset, which has advanced poleward at a rate of 5.5 days decade−1. A major change in the trends of FSS offset and duration occurred in the late 1980s. Earlier FSS offsets, ranging from 5 to 25 days, and resultant abbreviated durations are observed in western Europe, central and East Asia, and the mountainous western United States. Where regional changes in CSS were observed, most commonly there were shifts in both onset and offset dates toward earlier dates. Results indicate that it is important to pay close attention to spring snowmelt as an indicator of hemispheric climate variability and change.

ObjectiveTo assess the feasibility of balloon-occluded retrograde transvenous obliteration (BRTO) in active gastric variceal bleeding, and to compare the findings with those of transjugular intrahepatic portosystemic shunt (TIPS).Materials and MethodsTwenty-one patients with active gastric variceal bleeding due to liver cirrhosis were referred for radiological intervention. In 15 patients, contrast-enhanced CT scans demonstrated gastrorenal shunt, and the remaining six (Group 1) underwent TIPS. Seven of the 15 with gastrorenal shunt (Group 2) were also treated with TIPS, and the other eight (Group 3) underwent BRTO. All patients were followed up for 6 to 21 (mean, 14.4) months. For statistical inter-group comparison of immediate hemostasis, rebleeding and encephalopathy, Fisher's exact test was used. Changes in the Child-Pugh score before and after each procedure in each group were statistically analyzed by means of Wilcoxon's signed rank test.ResultsOne patient in Group 1 died of sepsis, acute respiratory distress syndrome, and persistent bleeding three days after TIPS, while the remaining 20 survived the procedure with immediate hemostasis. Hepatic encephalopathy developed in four patients (one in Group 1, three in Group 2, and none in Group 3); one, in Group 2, died while in an hepatic coma 19 months after TIPS. Rebleeding occurred in one patient, also in Group 2. Except for transient fever in two Group-3 patients, no procedure-related complication occurred. In terms of immediate hemostasis, rebleeding and encephalopathy, there were no statistically significant differences between the groups (p > 0.05). In Group 3, the Child-Pugh score showed a significant decrease after the procedure (p = 0.02).ConclusionBRTO can effectively control active gastric variceal bleeding, and because of immediate hemostasis, the absence of rebleeding, and improved liver function, is a good alternative to TIPS in patients in whom such bleeding, accompanied by gastrorenal shunt, occurs.

Findings of chronic segmental air-space consolidation that contained low-attenuation areas with peripheral enhancement or adjacent pleural thickening at CT were suggestive of thoracic actinomycosis.