OPTIMASI KAPASITAS PERSIMPANGAN BERSINYAL DENGAN MENGGUNAKAN METODE IHCM 1997 (STUDI KASUS PERSIMPANGAN JL.P.TENDEAN–JL.SAM RATULANGI MANADO)

Bagian jalan yang sering mengalami kemacetan adalah persimpangan sebidang seperti persimpangan Jalan Piere Tendean Boulevard – Jalan Sam Ratulangi yang merupakan persimpangan dengan kondisi lingkungan komersil serta sangat dekat dengan pusat kota (zero point). Kondisi ini mengakibatkan banyaknya kendaraan yang melakukan gerakan crossing pada persimpangan ini. Salah satu sistem yang dapat membantu mengatasi masalah ini yaitu dengan pengendalian arus lalu lintas dengan menggunakan signal lalu lintas.Tulisan ini berisi observasi dan penelitian tentang arus lalu lintas serta analisa tingkat pelayanan pada persimpangan bersinyal Jalan Piere Tendean Boulevard – Jalan Sam Ratulangi dengan metode IHCM 1997. Metode ini juga menganalisa beberapa pola gerakan alternatif pengontrolan yang memberikan hasil optimum diusulkan untuk dapat digunakan sebagai kemungkinan pengganti pengontrolan yang ada sekarang ini.Hasil analisa menunjukkan bahwa persimpangan Jalan Piere Tendean Boulevard – Jalan Sam Ratulangi memiliki 4 jam puncak dan total tundaan rata-rata dan tingkat pelayanan yang berbeda setiap jam puncaknya. Pada pukul 07.00-08.00 persimpangan memiliki total tundaan rata-rata 27,11 detik; pukul 09.00-10.00 dengan total tundaan rata-rata 29,06 detik; pukul 12.30-13.30 dengan total tundaan rata-rata 34,13 detik dan pukul 16.30-17.30 dengan total tundaan rata-rata 39,59 detik. Hasil analisa beberapa pola gerakan alternatif didapatkan yang terbaik yaitu pada pukul 07.00-08.00 persimpangan memiliki total tundaan rata-rata 14,60 detik; pukul 09.00-10.00 dengan total tundaan rata-rata 17,61 detik; pukul 12.30-13.30 dengan total tundaan rata-rata 20,76 detik dan pukul 16.30-17.30 dengan total tundaan rata-rata 28,53 detik.Kata kunci : persimpangan bersinyal, arus lalu lintas, tingkat pelayanan, pola gerakan alternati

Coeliac disease and ganglioneuroblastoma: An unusual association

[No abstract available

MR imaging of the small bowel using polyethylene glycol solution as an oral contrast agent in adults and children with celiac disease: preliminary observations.

OBJECTIVE. The purpose of our report is to describe morphologic abnormalities of the small bowel in a population of patients with known celiac disease using MR imaging with polyethylene glycol solution as an oral contrast agent. CONCLUSION. Polyethylene glycol-enhanced MR imaging is a noninvasive (no ionizing radiation is used), feasible, and reproducible imaging technique in both adult and pediatric populations. Findings on polyethylene glycol-enhanced MR imaging, similar to those of conventional barium studies, may suggest a diagnosis of celiac disease because the technique can not only reveal intestinal involvement but also show extraintestinal findings

A semielemental diet (Pregomin) as primary therapy for inducing remission in children with active Crohn's disease

Aims. To compare the efficacy of nutritional therapy alone versus corticosteroids for the treatment of a group of 20 children (median age: 12.4 years; range: 7-17 years) with active Crohn's disease. Nutritional therapy consisted of an extensively hydrolysed formula (Pregomin, Milupa) given for 8 weeks. Methods. Systemic diseases, food allergy, malabsorption syndromes and infectious disorders had been excluded in all. The patients underwent ileo-colonoscopy with biopsy and were clinically assessed according to the common pediatric Crohn's disease activity index (PCDAI). Patients were randomly allocated to receive either corticosteroids and mesalamine (group A) or nutritional therapy (group B). Patients were blindly evaluated clinically every two weeks and also endoscopically (with biopsy) at the end of the treatment. Results. At the end of the trial both treatments had been effective in reducing PCDAI (p < 0.01), endoscopic score (p < 0.01) and histological score (A: p < 0.05; B: p < 0.01); however, the nutritional group exhibited significantly lower post-trial scores than the corticosteroid group (p < 0.01). At 4 weeks after starting treatment PCDAI was significantly lower only in the nutritional group (p < 0.01). Clinical remission, defined as PCDAI < 10, was achieved in 9 (90%) patients in the nutritional group but only in 5 (50%) on corticosteroids (p < 0.01). Mean time elapsed to achieve remission was significantly shorter in the nutritional group than in the corticosteroid group (p < 0.05). Finally, nutritional therapy was more effective than corticosteroids in improving nutritional parameters such as serum ferritin, albumin and haemoglobin. Conclusion. A short course of an extensively hydrolysed formula given as sole therapy is more effective than corticosteroids in inducing clinical and inflammatory remission in children with active Crohn's disease. Nutritional treatment can be used as a first-line therapeutic approach in childhood with this condition