• Korean Journal of Radiology
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• v.19 no.6
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• pp.1089-1098
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• 2018

Objective: To investigate the diagnostic yield of contrast-enhanced computed tomography (CT) in Crohn's disease (CD) patients presenting with acute severe lower gastrointestinal bleeding (LGIB), and the role of CT in predicting the risk of rebleeding. Materials and Methods: A consecutive series of 110 CD patients presenting with acute severe LGIB between 2005 and 2016 were analyzed. Among them, 86 patients who had undergone contrast-enhanced CT constituted the study cohort. The diagnostic yield of CT for detecting contrast extravasation was obtained for the entire cohort and compared between different CT techniques. In a subgroup of 62 patients who had undergone CT enterography (CTE) and showed a negative result for extravasation on CTE, the association between various clinical and CTE parameters and the risk of rebleeding during subsequent follow-up was investigated using Cox regression analysis. Results: The diagnostic yield of CT was 10.5% (9 of 86 patients). The yield did not significantly differ between single-phase and multiphase examinations (p > 0.999), or between non-enterographic CT and CTE (p = 0.388). Extensive CD (adjusted hazard ratio [HR], 3.27; 95% confidence interval [CI], 1.09-9.80; p = 0.034) and bowel wall-to-artery enhancement ratio (adjusted HR, 2.81; 95% CI, 1.21-6.54; p = 0.016) were significantly independently associated with increased rebleeding risks, whereas anti-tumor necrosis factor-${\alpha}$ therapy after the bleeding independently decreased the risk of rebleeding (adjusted HR, 0.26; 95% CI, 0.07-0.95; p = 0.041). Conclusion: The diagnostic yield of contrast-enhanced CT was not high in CD patients presenting with acute severe LGIB. Nevertheless, even a negative CTE may be beneficial as it can help predict the risk of later rebleeding.

• Journal of the Korean Society of Marine Environment & Safety
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• v.28 no.4
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• pp.620-631
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• 2022

This paper shows the numerical prediction of the change in oil outflow rate according to the orifice shape of a damaged ship by using the computational fluid dynamics (CFD) analysis method. It also provides discharge coefficients for various orifice shapes to be used in theoretical prediction approaches. The oil outflow from the model ship was analyzed using a multiphase flow method under the condition that the Froude and Reynolds number similitudes were satisfied. The present numerical results were verified by comparing them with the available experimental data. Along with the aspect ratio of the orifice and the wall thickness of the cargo tank, the effects of the orifice shapes defined by mathematical figures on the oil outflow were investigated. To consider more realistic situations, the investigation of the ef ect of the crushed iron plate around the damaged part was also included. The numerical results confirmed the change in oil outflow time for various shapes of the damaged part of the oil tank, and discharge coefficients that quantify the viscous effects of those orifice shapes were extracted. To verify the predicted discharge coefficients, they were applied to an oil spill estimation equation. As a result, a good agreement between the CFD and theoretical results was obtained.