Analisa Pemilihan Moda Angkutan Kota Manado – Kota Gorontalo Menggunakan Model Binomial-logit-selisih

Aktifitas pergerakan antara kota Manado – kota Gorontalo merupakan pergerakan yang cukup padat. Pergerakan antara kedua kota tersebut dapat dilayani oleh dua moda yaitu bus dan mobil sewa. Angkutan bus lebih banyak diminati mengingat harga/biaya perjalanannya murah. Permasalahan moda bus dan mobil sewa ialah pergerakan penumpang rute Manado – Gorontalo yang cukup besar, tidak berimbang antara moda bus dan moda mobil sewa akibatnya penumpang yang menggunakan moda bus beralih ke moda mobil sewa dan tidal lagi memperhatikan faktor Kenyamanan dan keamanan penumpang. Melihat kondisi ini, semua pilihan diserahkan pada pengguna jasa yang mempertimbangkan cost/biaya, waktu tempuh dan waktu tunggu. Dari hasil analisa didapat suatu pemodelan antara moda bus dan moda mobil sewa yang diperoleh dengan persamaan linear y = 13,76 + 0,00165X1 + 1,655X2 + 6,998X3 dimana X1 adalah ∆Cost, X2 adalah ∆Waktu Tempuh dan X3 adalah ∆Waktu Tunggu. Dari persamaan tersebut dapat diperoleh model pemilihan moda transportasi yang menjelaskan probabilitas pelaku perjalanan dalam memilih moda bus dan moda mobil sewa

Diagnostic Approach and Treatment of Choledocholithiasis

Choledocolithiasis may cause acute cholangitis which is life-threatening condition. It has non specific clinical signs from mild to severe condition such as septicemia. Diagnostic and treatment modalities had developed a great deal recently. Therapeutic options include endoscopic retrograde cholangio pancreatography (ERCP),common bile duct exploration (CBDE), laparoscopic CBDE and stone retrieval. The important thing is to choose the appropriate method for each patient. We reported a case of choledocolithiasis in 40 years old, male patients who was clinically diagnosed as acute cholangitis. Diagnostic approach to find the etiology was done. Abdominal USG and CT were performed and showed multiple stones in gallbladder and intrahepatic biliary duct, suspected mass at caput of the pancreas and hepatomegaly. The ERCP showed dilatation of intra and extra hepatic biliary ducts with multiple stone in common bile duct (CBD), hepatic duct and gallbladder. The stent was placed for biliary drainage. The patient underwent cholecystectomy per laparoscopy, but further evaluation of the cholangiography still showed the presence of stones in intrahepatic biliary duct. Laparotomy exploration of CBD was done and it revealed multiple stones and dilatation of distal CBD. Surgical treatment selected for this case was choledocojejunostomy