• Title/Summary/Keyword: Automated

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Feasibility of Automated Detection of Inter-fractional Deviation in Patient Positioning Using Structural Similarity Index: Preliminary Results (Structural Similarity Index 인자를 이용한 방사선 분할 조사간 환자 체위 변화의 자동화 검출능 평가: 초기 보고)

  • Youn, Hanbean;Jeon, Hosang;Lee, Jayeong;Lee, Juhye;Nam, Jiho;Park, Dahl;Kim, Wontaek;Ki, Yongkan;Kim, Donghyun
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.258-266
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    • 2015
  • The modern radiotherapy technique which delivers a large amount of dose to patients asks to confirm the positions of patients or tumors more accurately by using X-ray projection images of high-definition. However, a rapid increase in patient's exposure and image information for CT image acquisition may be additional burden on the patient. In this study, by introducing structural similarity (SSIM) index that can effectively extract the structural information of the image, we analyze the differences between daily acquired x-ray images of a patient to verify the accuracy of patient positioning. First, for simulating a moving target, the spherical computational phantoms changing the sizes and positions were created to acquire projected images. Differences between the images were automatically detected and analyzed by extracting their SSIM values. In addition, as a clinical test, differences between daily acquired x-ray images of a patient for 12 days were detected in the same way. As a result, we confirmed that the SSIM index was changed in the range of 0.85~1 (0.006~1 when a region of interest (ROI) was applied) as the sizes or positions of the phantom changed. The SSIM was more sensitive to the change of the phantom when the ROI was limited to the phantom itself. In the clinical test, the daily change of patient positions was 0.799~0.853 in SSIM values, those well described differences among images. Therefore, we expect that SSIM index can provide an objective and quantitative technique to verify the patient position using simple x-ray images, instead of time and cost intensive three-dimensional x-ray images.

Incidence of hearing loss and importance of risk factors in the neonatal intensive care unit (신생아 중환자실에서 난청의 발생빈도 및 위험요소의 중요성)

  • Kong, Seung Hyun;Kang, Jang Hee;Hwang, Kwang Su;Kim, Joong Pyo;Lee, Hyeon Jung;Choi, Hyeon;Mok, Ji Sun;Kim, Jung Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.845-850
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    • 2006
  • Purpose : To assess the incidence of neonatal hearing loss in a neonatal intensive care unit and the relative importance of risk factors for hearing imparement in a neonatal intensive care unit which the Joint Committee on Infant Hearing(JCIH) had recommended. Methods : One thousand, two hundred and one newborns admitted to the Good Moonhwa Intensive Care Unit from May 2003 to December 2005 were assesed using the automated auditory brainstem response(AABR). The screening was performed on those aged more than 36 weeks and weighing more than 2,200 g. We divided the infants into two groups, 'pass' and 'refer'. The 'refer' group were retested one month later, and if classified as 'refer' during the retest, were referred to a hearing impairment clinic. Results : From the 1,201 neonates, 1,187(98.8 percent) passed the test and 14(1.2 percent) failed. 293(24.4 percent) of the 1,201 neonates had a risk factor for hearing impairment; 282(96.2 percent) passed the test and 11(3.8 percent) failed. The group with risk factors were shown to have a higher incidence of hearing loss(P<0.001). The neonates in the refer group were shown to have a higher incidence of ototoxic drugs(P<0.001), low birth weight(<1,500 g)(P<0.001) and craniofacial anomalies(P=0.007). On the other hand, there were no statistical differences between the pass and refer groups in congenital infection, hyperbilirubinemia, bacterial meningitis, low Apgar scores, prolonged mechanical ventilation and syndromes known to include hearing loss. Conclusion : In order to identify hearing-impaired infants within an appropriate period, neonatal hearing screening tests and identification of the risk factors for neonatal hearing loss are important.

Risk Factors in Relation to Blood Pressure in Schoolchildren (국민학교 학동의 혈압에 관련된 요인분석)

  • Lee, Dong-Soo;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.345-359
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    • 1993
  • This study was conducted to identify the factors related to the blood pressure in school children. The study subjects were 144 boys and 140 girls aged 10 years old, 4th grade student of one elementary school in Taegu City. Blood pressure and 18 variables for 284 school children were measured in May 1992. A weight-for-height index, R$\ddot{o}$hrer index(weight/$height^3$) was calculated for each individual as a measure of obesity. Body fat percent, fat weight, and lean body mass were measured by impedance fat meter(Model SIF-891). Serum total cholesterol, high-density lipoprotein, triglyceride, uric acid, total protein, and electrolyte were measured by automated clinical chemistry analyzer(Hitachi 4020). Low-density lipoprotein and atherogenic index were calculated by the equation. The variables assessed were sex, systolic blood pressure, diastolic blood pressure. R$\ddot{o}$hrer index, body fat percent, body fat weight, lean body mass, total cholesterol, high-density lipoprotein, low-density lipoprotein, uric acid, total protein, serum electrolyte and blood glucose. The mean systolic and diastolic blood pressures for boys were 104.1mmHg and 66.6mmHg and those for girls were 102.9mmHg and 67.5mmHg. Systolic blood pressure of boys was positively correlated with height, weight, R$\ddot{o}$hrer index, fat weight, lean body mass, and triglyceride. Systolic blood pressure of girls was positively correlated with height, weight, lean body mass, and uric acid. Diastolic blood pressure of boys was positively correlated with weight. R$\ddot{o}$hrer index, and lean body mass. Diastolic blood pressure of girls was positively correlated with height, weight, fat weight, and lean body mass and negatively with total serum protein. In multiple regression analysis for the systolic blood pressure, the significant independent variables were R$\ddot{o}$hrer index and serum sodium in boys, and serum uric acid, fat percent, and R$\ddot{o}$hrer index in girls. In multiple regression analysis of the diastolic blood pressure, the significant independent variables were R$\ddot{o}$hrer index in boys and total serum protein in girls. This study indicated that important factors influencing blood pressure in school children were R$\ddot{o}$hrer index, fat percent, serum sodium, uric acid, and total protein. R$\ddot{o}$hrer index was most important among these. It is recommended to enforce the nutritional education for diet control of obesity to prevent hypertention in children and to adopt healthy life-styles that promote good health and prevent development of cardiovascular risk factors.

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Serum Beta-2 Microglobulin: a Possible Marker for Disease Progression in Egyptian Patients with Chronic HCV Related Liver Diseases

  • Ouda, SM;Khairy, AM;Sorour, Ashraf E;Mikhail, Mikhail Nasr
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7825-7829
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    • 2015
  • Background: Egypt has the highest prevalence of HCV infection in the world (~14.7%). Around 10-15% of HCV-infected persons will advance to cirrhosis within the first 20 years. The incidence of HCC is expected to grow in the next two decades, largely due to HCV related cirrhosis, and detection of HCC at an early stage is critical for a favorable clinical outcome. No simple reliable non-invasive marker has been available till now. B2M, a non-glycosylated polypeptide composed of 99 amino acids, is one of the components of HLA class I molecules on the surfaces of all nucleated cells. It has been reported that the level of serum B2M is elevated in patients with chronic hepatitis C and HCV-related HCC when compared to HCV-negative patients or healthy donors. Determining the clinical utility of serum B2M as a marker for disease progression in Egyptian patients with HCV related chronic hepatitis, cirrhosis and hepatocellular carcinoma was the aim of the present study. Materials and Methods: In this analytical cross sectional study 92 participants were included in 4 equal groups: Group (1) non cirrhotic chronic HCV; Group (2) HCV related liver cirrhosis; Group (3) HCC on top of HCV,; and Group (4) healthy controls. History taking, clinical examination, routine labs and abdominal ultrasound were conducted for all patients, PCR and Metavir scores for group (1) patients, and triphasic CT abdomen and AFP for Group (3) patients. B2M levels were measured in serum with a fully-automated IMX system. Results: The mean serum B2M level of Group (1) was $4.25{\pm}1.48{\mu}g/ml$., Group (2) was $7.48{\pm}3.04$, Group (3) was $6.62{\pm}2.49$ and Group (4) was $1.62{\pm}0.63$. Serum B2M levels were significantly higher in diseased than control group (p<0.01) being significantly higher in cirrhosis ($7.48{\pm}3.04$) and HCC groups ($6.62{\pm}2.49$) than the HCV group ($4.25{\pm}1.48$) (p<0.01). There was a significant correlation between B2M Level and ALK, total and direct bilirubin and INR (p<0.05), and a significant inverse correlation between B2M level and albumin, total proteins, HB andWBCS values (p<0.05). There was no significant correlation between B2M level and viral load or Metavir score, largest tumour size or AFP (p>0.05). The best B2M cut-off for HCV diagnosis was 2.6 with a sensitivity of 100%, a specificity of 92%, a positive predictive value (PPV) of 97% and a negative predictive value (NPV) of 100%. The best B2M cut-off for HCC diagnosis was 4.55 which yielded sensitivity, specificity, positive predictive value, negative predictive values of 74%, 62%, 39.5, 87.8% respectively (p-value <0.01) while best cut-off for cirrhosis was 4.9, with sensitivity 74 % and specificity 74%.The sensitivity for HCC diagnosis increased upon B2M and AFP combined estimation to 91%, specificity to 79%, NPV to 95% and accuracy to 83%. Conclusions: Serum B2M level is elevated in HCV related chronic liver diseases and may be used as a marker for HCV disease progression towards cirrhosis and carcinoma.

Evaluating efficiency of automatic surface irrigation for soybean production

  • Jung, Ki-yuol;Lee, Sang-hun;Chun, Hyen-chung;Choi, Young-dae;Kang, Hang-won
    • Proceedings of the Korean Society of Crop Science Conference
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    • 2017.06a
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    • pp.252-252
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    • 2017
  • Nowadays water shortage is becoming one of the biggest problems in the Korea. Many different methods are developed for conservation of water. Soil water management has become the most indispensable factor for augmenting the crop productivity especially on soybean (Glycine max L.) because of their high susceptibility to both water stress and water logging at various growth stages. The farmers have been using irrigation techniques through manual control which farmers irrigate lands at regular intervals. Automatic irrigation systems are convenient, especially for those who need to travel. If automatic irrigation systems are installed and programmed properly, they can even save you money and help in water conservation. Automatic irrigation systems can be programmed to provide automatic irrigation to the plants which helps in saving money and water and to discharge more precise amounts of water in a targeted area, which promotes water conservation. The objective of this study was to determine the possible effect of automatic irrigation systems based on soil moisture on soybean growth. This experiment was conducted on an upland field with sandy loam soils in Department of Southern Area Crop, NICS, RDA. The study had three different irrigation methods; sprinkle irrigation (SI), surface drip irrigation (SDI) and fountain irrigation (FI). SI was installed at spacing of $7{\times}7m$ and $1.8m^3/hr$ as square for per irrigation plot, a lateral pipe of SDI was laid down to 1.2 m row spacing with $2.3L\;h^{-1}$ discharge rate, the distance between laterals was 20 cm spacing between drippers and FI was laid down in 3m interval as square for per irrigation plot. Soybean (Daewon) cultivar was sown in the June $20^{th}$, 2016, planted in 2 rows of apart in 1.2 m wide rows and distance between hills was 20 cm. All agronomic practices were done as the recommended cultivation. This automatic irrigation system had valves to turn irrigation on/off easily by automated controller, solenoids and moisture sensor which were set the reference level as available soil moisture levels of 30% at 10cm depth. The efficiency of applied irrigation was obtained by dividing the total water stored in the effective root zone to the applied irrigation water. Results showed that seasonal applied irrigation water amounts were $60.4ton\;10a^{-1}$ (SI), $47.3ton\;10a^{-1}$ (SDI) and $92.6 ton\;10a^{-1}$ (FI), respectively. The most significant advantage of SDI system was that water was supplied near the root zone of plants drip by drip. This system saved a large quantity of water by 27.5% and 95.6% compared to SI, FI system. The average soybean yield was significantly affected by different irrigation methods. The soybean yield by different irrigation methods were $309.7kg\;10a^{-1}$ from SDI $282.2kg\;10a^{-1}$ from SI, $289.4kg\;10a^{-1}$ from FI, and $206.3kg\;10a^{-1}$ from control, respectively. SDI resulted in increase of soybean yield by 50.1%, 7.0% 9.8% compared to non-irrigation (control), FI and SI, respectively. Therefore, the automatic irrigation system supplied water only when the soil moisture in the soil went below the reference. Due to the direct transfer of water to the roots water conservation took place and also helped to maintain the moisture to soil ratio at the root zone constant. Thus the system is efficient and compatible to changing environment. The automatic irrigation system provides with several benefits and can operate with less manpower. In conclusion, improving automatic irrigation system can contribute greatly to reducing production costs of crops and making the industry more competitive and sustainable.

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Fully Automated Liquid Culture System Compared with Lowenstein-Jensen Solid Medium for Rapid Recovery of Mycobacteria in Sputums (완전 자동화된 액체배양법과 기존의 고체배양법을 이용한 객담 내 mycobacterium의 신속검출에 대한 비교)

  • Park, Seung-Kyu;Kim, Seung-Chul;Kim, Deuk-Mi;Lee, Chang-Woon;Kim, Young;Cho, Sang-Nae
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.635-643
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    • 2002
  • Background : The Aim of this study was to compare the recovery of mycobacteria from sputum samples of pulmonary tuberculosis patients using the MB/BacT rapid culture system(Organon Teknika, USA) with that obtained using Lowenstein-Jensen solid medium. Methods : The two culture systems were compared using sputum samples of 99 pulmonary tuberculosis patients. Culture media were incubated at $35-37^{\circ}C$ for six weeks in the MB/BacT system and for 12 weeks in Lowenstein-Jensen solid medium. Solid media were examined macroscopically once a week, and the MB/BacT system positive vials were unloaded from the machine as soon as possible after positive signal from the connected computer was detected Confirmation of growth for mycobacteria was done by Ziehl-Neelson stained smears. Isolates were identified to differentiate Mycobacterium tuberculosis from mycobacterium other than tuberculosis(MOTT) by phenotypic and molecular methods. Results : Of the sputum samples of the 99 patients, 58 samples were smear positive and 41 in negative smear. Mycobacteria were recovered from 67(67.7%) samples by using both culture systems. The yield with MB/BacT was higher than that with Lowenstein-Jensen [67(67.7%) vs. 52(52.5%), p<0.001]. Moreover, 15(15.2%) samples were positive only in the MB/BacT, whereas none of samples was positive only in Lowenstein-Jensen. In smear-positive and smear-negative samples, the recovery rate with MB/BacT was also higher than that with Lowenstein-Jensen [sputum-positive; 56/58(96.6%) vs. 46/58(79.3%), p=0.005, sputum-negative; 6/41(14.6%) vs. 5/41(12.2%), p<0.001]. The mean times to detection of Mycobacteria were 13.3 and 27.2 days with MB/BacT and Lowenstein-Jensen respectively(p<0.001). Conclusion : This results indicate that the the MB/BacT is more efficient and faster than Lowenstein-Jensen for the recovery of mycobacteria.

The Factors Influencing Survival of Out-of-hospital Cardiac Arrest with Cardiac Etiology (병원 밖에서 발생한 심인성 심장정지환자의 생존 관련 요인 7년간 국가심장정지조사사업 자료 활용)

  • Jeong, Su-Yeon;Kim, Chul-Woung;Hong, Sung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.560-569
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    • 2016
  • Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.

Outcomes of Chronic Peritoneal Dialysis by Various Modalities in Korean Children - A Single Center Study (소아 환자에서 다양한 복막투석 방법간의 결과 비교-단일기관 연구)

  • Lee, Sung-Ha;Baek, Jae-Suk;Lee, Hyun-Kyung;Han, Kyoung-Hee;Choi, Hyun-Jin;Lee, Bum-Hee;Cho, Hee-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.255-263
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    • 2007
  • Purpose : A single center cross sectional retrospective study was performed to compare the outcomes of different peritoneal dialysis(PD) modalities in Korean children. Methods : Among children dialyzed with PD between the year 2004 and 2007, 35 children had reliable data on PD adequacy after 3 to 15 months of dialysis. Subjects were grouped by their modalities; 17, 13 and 5 children were on continuous ambulatory PD(CAPD), continuous cyclic PD(CCPD) and nightly intermittent PD(NIPD), respectively. Body weight and height, number of patients taking anti-hypertensives and laboratory data including biochemical and hemoglobin levels were compared. Dialysis adequacy including weekly Kt/Vurea, creatinine clearance (Ccr) and daily water removal were also compared. Patients were sub-grouped by their peritoneal permeability characteristics. Results : The percentage of patients taking anti-hypertensives, monthly change in Z-scores of body weight and height and laboratory data did not differ among the groups. Patients on CAPD and CCPD showed similar dialysis adequacies. Weekly dialytic Ccr was significantly lower in the NIPD group compared to the others. But total Ccr was not different when residual renal function was added. Weekly dialytic Ccr by CAPD was significantly higher than that of CCPD in low and low-average transporters. Conclusion : We propose that modality can be selected flexibly according to the patients' preferences. And peritoneal permeability characteristics provide valuable information for adjusting PD prescriptions in ultrafiltration failure or in inadequate dialysis. Further study of other clinical performance measures should be performed to clarify the comparable outcomes in different PD modalities.

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Development of Broad-range and Specific 16S rRNA PCR for Use in Routine Diagnostic Clinical Microbiology (임상미생물 검출을 위한 광대한 범위와 특이도를 가지는 16S rRNA PCR법 개발)

  • Kim, Hyun-Chul;Kim, Yun-Tae;Kim, Hyogyeong;Lee, Sanghoo;Lee, Kyoung-Ryul;Kim, Young-Jin
    • Journal of Life Science
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    • v.24 no.4
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    • pp.361-369
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    • 2014
  • Broad-range and specific 16S rRNA gene PCR is used for detection and identification of bacterial pathogens in clinical specimens from patients with a high suspicion for infection. We describe the development of a broad-range and specific PCR primer, based on bacterial 16S rRNA, for use in routine diagnostic clinical microbiology services. The primers were designed by using conservative regions of 16S rRNA sequences from 10 strains. Ninety-eight clinical strains were isolated from clinical patient specimens. A total of 98 strains of bacteria were identified by phenotypic methods; PCR with newly designed primers and universal primers. All purified PCR products were sequenced using both forward and reverse primers on an automated DNA analyzer. In this study, we evaluated the usefulness of the newly designed primers and the universal primers for the detection of bacteria, and both these techniques were compared with phenotypic methods for bacteria detection. When we also tested 98 strains of clinical isolates with newly designed primers, about 778 bp DNA fragments were amplified and identified from all strains. Of the 98 strains, 94 strains (95.9%) correspond in comparison with phenotypic methods. The newly designed primers showed that the identities of 98 (100%) strains were the same as those obtained by universal PCR primers. The overall agreement between the newly designed primers and universal primers was 100%. The primer set was designed for rapid, accurate, and cheap identification of bacterial pathogens. We think the newly designed primer set is useful for the identification of pathogenic bacteria.

A Quantification Method for the Cold Pool Effect on Nocturnal Temperature in a Closed Catchment (폐쇄집수역의 냉기호 모의를 통한 일 최저기온 분포 추정)

  • Kim, Soo-Ock;Yun, Jin-I.
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.13 no.4
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    • pp.176-184
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    • 2011
  • Cold air on sloping surfaces flows down to the valley bottom in mountainous terrain at calm and clear nights. Based on the assumption that the cold air flow may be the same as the water flow, current models estimate temperature drop by regarding the cold air accumulation at a given location as the water-like free drainage. At a closed catchment whose outlet is blocked by man-made obstacles such as banks and roads, however, the water-like free drainage assumption is no longer valid because the cold air accumulates from the bottom first. We developed an empirical model to estimate quantitatively the effect of cold pool on nocturnal temperature in a closed catchment. In our model, a closed catchment is treated like a "vessel", and a digital elevation model (DEM) was used to calculate the maximum capacity of the cold pool formed in a closed catchment. We introduce a topographical variable named "shape factor", which is the ratio of the cold air accumulation potential across the whole catchment area to the maximum capacity of the cold pool to describe the relative size of temperature drop at a wider range of catchment shapes. The shape factor is then used to simulate the density profile of cold pool formed in a given catchment based on a hypsometric equation. The cold lake module was incorporated with the existing model (i.e., Chung et al., 2006), generating a new model and predicting distribution of minimum temperature over closed catchments. We applied this model to Akyang valley (i.e., a typical closed catchment of 53 $km^2$ area) in the southern skirt of Mt. Jiri National Park where 12 automated weather stations (AWS) are operational. The performance of the model was evaluated based on the feasibility of delineating the temperature pattern accurately at cold pool forming at night. Overall, the model's ability of simulating the spatial pattern of lower temperature were improved especially at the valley bottom, showing a similar pattern of the estimated temperature with that of thermal images obtained across the valley at dawn (0520 to 0600 local standard time) of 17 May 2011. Error in temperature estimation, calculated with the root mean square error using the 10 low-lying AWSs, was substantially decreased from $1.30^{\circ}C$ with the existing model to $0.71^{\circ}C$ with the new model. These results suggest the feasibility of the new method in predicting the site-specific freeze and frost warning at a closed catchment.