A direct force on the superior aspect of the shoulder may cause acromioclavicular(AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual lab...A direct force on the superior aspect of the shoulder may cause acromioclavicular(AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual laborer. The dislocation is classified according to Rockwood. Types Ⅰ?and Ⅱ are treated nonoperatively, while types Ⅳ, Ⅴ and Ⅵ are generally treated operatively. Controversy exists regarding the optimal treatment of type Ⅲ dislocations in the high-demand patient. Recent evidence suggests that these should be treated nonoperatively initially. Classic surgical techniques were associated with high complication rates, including recurrent dislocations and hardware breakage. In recent years, many new techniques have been introduced in order to improve the outcomes. Arthroscopic reconstruction or repair techniques have promising short-term results. This article aims to provide a current concepts review on the treatment of AC dislocations with emphasis on recent developments.展开更多
We consider the permeability estimation problem in two-phase porous media flow. We try to identify the permeability field by utilizing both the production data from wells as well as inverted seismic data. The permeabi...We consider the permeability estimation problem in two-phase porous media flow. We try to identify the permeability field by utilizing both the production data from wells as well as inverted seismic data. The permeability field is assumed to be piecewise constant, or can be approximated well by a piecewise constant function. A variant of the level set method, called Piecewise Constant Level Set Method is used to represent the interfaces between the regions with different permeability levels. The inverse problem is solved by minimizing a functional, and TV norm regularization is used to deal with the ill-posedness. We also use the operator-splitting technique to decompose the constraint term from the fidelity term. This gives us more flexibility to deal with the constraint and helps to stabilize the algorithm.展开更多
AIM:To assesses the safety and efficacy of Aspergillus niger prolyl endoprotease(AN-PEP)to mitigate the im-munogenic effects of gluten in celiac patients.METHODS:Patients with initial diagnosis of celiac disease as co...AIM:To assesses the safety and efficacy of Aspergillus niger prolyl endoprotease(AN-PEP)to mitigate the im-munogenic effects of gluten in celiac patients.METHODS:Patients with initial diagnosis of celiac disease as confirmed by positive serology with subtotal or total villous atrophy on duodenal biopsies who adhere to a strict gluten-free diet(GFD)resulting in normalised antibodies and mucosal healing classified as Marsh 0 orⅠwere included.In a randomised double-blind placebo-controlled pilot study,patients consumed toast(approximately 7 g/d gluten)with AN-PEP for 2 wk(safety phase).After a 2-wk washout period with adherence of the usual GFD,14 patients were randomised to gluten intake with either AN-PEP or placebo for 2 wk(efficacy phase).Measurements at baseline included complaints,quality-of-life,serum antibodies,immunophenotyping of T-cells and duodenal mucosa immunohistology.Furthermore,serum and quality of life questionnaires were collected during and after the safety,washout and efficacy phase.Duodenal biopsies were collected after the safety phase and after the efficacy phase.A change in histological evaluation according to the modified Marsh classification was the primary endpoint.RESULTS:In total,16 adults were enrolled in the study.No serious adverse events occurred during the trial and no patients withdrew during the trial.The mean score for the gastrointestinal subcategory of the celiac disease quality(CDQ)was relatively high throughout the study,indicating that AN-PEP was well tolerated.In the efficacy phase,the CDQ scores of patients consuming gluten with placebo or gluten with AN-PEP did not significantly deteriorate and moreover no differences between the groups were observed.During the efficacy phase,neither the placebo nor the AN-PEP group developed significant antibody titers.The IgA-EM concentrations remained negative in both groups.Two patients were excluded from entering the efficacy phase as their mucosa showed an increase oftwo Marsh steps after the safety phase,yet with undetectable se展开更多
This current concepts review outlines the role of diffe-rent imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articul...This current concepts review outlines the role of diffe-rent imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone(usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography(CT) and magnetic resonance imaging(MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available.展开更多
The elbow joint is a complex joint, which, when impaired in function, leads to severe disability. In some cases however, an arthroplasty might be an appropriate treatment. In the past four decades, large steps havebee...The elbow joint is a complex joint, which, when impaired in function, leads to severe disability. In some cases however, an arthroplasty might be an appropriate treatment. In the past four decades, large steps havebeen taken to optimize this treatment in order to achieve better post-operative outcomes. To understand these progresses and to discover aspects for upcoming improvements, we present a review on the past developments, the present state of affairs and future developments which may improve patient care further.展开更多
Optokinetic nystagmus (OKN) is rhythmic eye movements, back and forth, with a slow and fast phase when the eyes are presented for full-field visual stimulus. OKN was recorded in a healthy subject for four conditions, ...Optokinetic nystagmus (OKN) is rhythmic eye movements, back and forth, with a slow and fast phase when the eyes are presented for full-field visual stimulus. OKN was recorded in a healthy subject for four conditions, stripes moving 30<span style="white-space:nowrap;">°</span>/s left and right and 60<span style="white-space:nowrap;">°</span>/s left and right. In this paper, surrogate data analysis was applied to test the Hurst exponents for increasing time horizons for the integrated OKN amplitude sequences statistically against 100 shuffled sequences (<em>i.e.</em>, the serial dependency of the original data sequences is broken by changing the order of the sequence). The result shows that the pattern of the OKN amplitude sequence scales statistically different (<em>p</em> < 0.01) compared to random permutations of the same numbers for scaling shorter than 16 nystagmus components (slow and fast phases) for all four test conditions.展开更多
Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,whi...Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,which can easily be overlooked on the initial standard radiographs.The treatment options for proximal radius fractures in children range from non-surgical treatment,such as immobilization alone and closed reduction followed by immobilization,to more invasive options,including closed reduction with percutaneous pinning and open reduction with internal fixation.The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient;an angulation of less than 30 degrees and translation of less than 50%is generally accepted,whereas a higher degree of displacement is considered an indication for surgical intervention.Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures,range of motion and complications compared to severely displaced fractures requiring surgical intervention.With proper management,good to excellent results are achieved in most cases,and long-term sequelae are rare.However,severe complications do occur,including radio-ulnar synostosis,osteonecrosis,rotational impairment,and premature physeal closure with a malformation of the radial head as a result,especially after more invasive procedures.Adequate follow-up is therefore warranted.展开更多
Culturable fungal population diversity and succession was investigated in developing cranberry ovaries of fruit rot-resistant and rot-susceptible cranberry selections,from flower through mature fruit.Fungi were recove...Culturable fungal population diversity and succession was investigated in developing cranberry ovaries of fruit rot-resistant and rot-susceptible cranberry selections,from flower through mature fruit.Fungi were recovered in culture from 1185 of 1338 ovary tissues collected from June to September,yielding 2255 isolates that represented 42 morphotaxa.During the season,species richness varied from 2 to 17 and 2 to 18 in rot-resistant and rotsusceptible selections,respectively,increasing from wk1 to wk10 and then gradually declining to wk14.Shannon-Wiener diversity index varied from 0.27 to 2.32 in rotresistant and 0.18 to 2.38 in rot-susceptible,and Pielou’s evenness index varied from 0.11 to 0.63 and 0.06 to 0.64 in rot-resistant and rot-susceptible selections,respectively,confirming that diversity of fungi in developing ovaries was similar among rot-resistant and rot-susceptible selections,but varied among sampling time points.Principal component analysis grouped samples collected at the same sampling time point together regardless of rot susceptibility of the selections,and detected the predominant fungal species associated with each stage of development.Successional changes were observed in populations of endophytic,pathogenic and saprophytic fungi throughout the season as ovaries matured.展开更多
A new Epichloëspecies distributed in Africa,Europe,North America and South America on host genera Bromus,Festuca,Lolium and Poa is described.Stromata,characteristic of the genus,frequently occurred on the reprodu...A new Epichloëspecies distributed in Africa,Europe,North America and South America on host genera Bromus,Festuca,Lolium and Poa is described.Stromata,characteristic of the genus,frequently occurred on the reproductive tillers of Poa secunda subsp.juncifolia,but neither perithecia nor mature asci were observed.Conidiogenous cells and conidial characteristics were in the range of Epichloëtyphina.Regions of the genes encodingβ-tubulin(tub2)and translation elongation factor 1-α(tef1)were amplified and sequenced.Phylogenetic analyses of these sequences grouped the Poa secunda subsp.juncifolia endophyte into one group within a non-hybrid Epichloëspecies complex.On the basis of morphology,host range and evolutionary history we propose that this endophyte represents a new species of Epichloë.The name Epichloëpoae is proposed for this endophyte.The infectivity of the conidia produced on plants was evaluated.In the first experiment,using conidia of Epichloëpoae from leaves and endophytefree seeds of Poa secunda subsp.juncifolia we show that when germinating seeds and developing seedlings of the plant were exposed to conidia,28–57%of seedlings became infected by the endophyte.The non-inoculated control plants showed no colonization by the endophyte.In the following spring after vernalization,colonized plants on flowering culms produced stromata with conidia.In the second experiment,using stromal conidia and the same procedure,19–42%of seedlings of Poa secunda subsp.juncifolia became colonized by the endophyte.Our results demonstrate that Epichloëpoae may spread to uninfected grass hosts by conidia frequently formed on the surfaces of plant leaves as well as by conidia formed on stromata.展开更多
Macrophages play an important role in immunity and homeostasis. Upon pathogen recognition via specific receptors, they rapidly induce inflammatory responses. This process is tightly controlled at the transcriptional l...Macrophages play an important role in immunity and homeostasis. Upon pathogen recognition via specific receptors, they rapidly induce inflammatory responses. This process is tightly controlled at the transcriptional level. The DNA binding zinc-finger protein CCCTC-binding factor （Ctcf） is a crucial regulator of long-range chromatin interactions and coordinates specific communication between transcription factors and gene expression processes. In this study, the Ctcf gene was specifically deleted in myeloid cells by making use of the transgenic Cre-LoxP system. Conditional deletion of the Ctcfgene in myeloid cells induced a mild phenotype in vivo. Ctcf-deficient mice exhibited significantly reduced expression of major histocompatibility complex （MHC） class II in the liver. Ctcf-deficient macrophages demonstrated a normal surface phenotype and phagocytosis capacity. Upon Toll-like receptor （TLR） stimulation, they produced normal levels of the pro-inflammatory cytokines IL-12 and IL-6, but manifested a strongly impaired capacity to produce tumor-necrosis factor （TNF） and IL-IO, as well as to express the IL-IO family members IL-19, IL-20 and IL-24. Taken together, our data demonstrate a role of Ctcf that involves fine-tuning of macrophage function.展开更多
Acute septic arthritis in children is an orthopaedic emergency.A delay in diagnosis and inappropriate treatment can result in devastating damage to the joint with lifelong disability as a consequence.The clinical pres...Acute septic arthritis in children is an orthopaedic emergency.A delay in diagnosis and inappropriate treatment can result in devastating damage to the joint with lifelong disability as a consequence.The clinical presentation can be a diagnostic challenge,especially in young children.A recent systematic review showed that joint tenderness and fever are important signals of septic arthritis.Ultrasound is helpful in detecting the presence of a joint effusion.Plain radiographs may show bone changes but magnetic resonance imaging is the most reliable imaging study for detecting concomitant osteomyelitis.The diagnosis of acute septic arthritis is highly suggestive when pus is aspirated from the joint,in case of a positive culture or a positive gram stain of the joint fluid,or if there is a white blood-cell count in the joint fluid of more than 50000/mm3.Staphylococcus aureus is the most commonly cultured organism.Recent systematic reviews have identified the most effective drainage techniques,including needle aspiration,arthroscopy and arthrotomy,depending on the affected joint.After the drainage procedure it is important to monitor the clinical and laboratory outcomes.Additional drainage procedures may be necessary in select cases.展开更多
文摘A direct force on the superior aspect of the shoulder may cause acromioclavicular(AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual laborer. The dislocation is classified according to Rockwood. Types Ⅰ?and Ⅱ are treated nonoperatively, while types Ⅳ, Ⅴ and Ⅵ are generally treated operatively. Controversy exists regarding the optimal treatment of type Ⅲ dislocations in the high-demand patient. Recent evidence suggests that these should be treated nonoperatively initially. Classic surgical techniques were associated with high complication rates, including recurrent dislocations and hardware breakage. In recent years, many new techniques have been introduced in order to improve the outcomes. Arthroscopic reconstruction or repair techniques have promising short-term results. This article aims to provide a current concepts review on the treatment of AC dislocations with emphasis on recent developments.
基金the Norwegian Research Council,Petromaks Programme
文摘We consider the permeability estimation problem in two-phase porous media flow. We try to identify the permeability field by utilizing both the production data from wells as well as inverted seismic data. The permeability field is assumed to be piecewise constant, or can be approximated well by a piecewise constant function. A variant of the level set method, called Piecewise Constant Level Set Method is used to represent the interfaces between the regions with different permeability levels. The inverse problem is solved by minimizing a functional, and TV norm regularization is used to deal with the ill-posedness. We also use the operator-splitting technique to decompose the constraint term from the fidelity term. This gives us more flexibility to deal with the constraint and helps to stabilize the algorithm.
文摘AIM:To assesses the safety and efficacy of Aspergillus niger prolyl endoprotease(AN-PEP)to mitigate the im-munogenic effects of gluten in celiac patients.METHODS:Patients with initial diagnosis of celiac disease as confirmed by positive serology with subtotal or total villous atrophy on duodenal biopsies who adhere to a strict gluten-free diet(GFD)resulting in normalised antibodies and mucosal healing classified as Marsh 0 orⅠwere included.In a randomised double-blind placebo-controlled pilot study,patients consumed toast(approximately 7 g/d gluten)with AN-PEP for 2 wk(safety phase).After a 2-wk washout period with adherence of the usual GFD,14 patients were randomised to gluten intake with either AN-PEP or placebo for 2 wk(efficacy phase).Measurements at baseline included complaints,quality-of-life,serum antibodies,immunophenotyping of T-cells and duodenal mucosa immunohistology.Furthermore,serum and quality of life questionnaires were collected during and after the safety,washout and efficacy phase.Duodenal biopsies were collected after the safety phase and after the efficacy phase.A change in histological evaluation according to the modified Marsh classification was the primary endpoint.RESULTS:In total,16 adults were enrolled in the study.No serious adverse events occurred during the trial and no patients withdrew during the trial.The mean score for the gastrointestinal subcategory of the celiac disease quality(CDQ)was relatively high throughout the study,indicating that AN-PEP was well tolerated.In the efficacy phase,the CDQ scores of patients consuming gluten with placebo or gluten with AN-PEP did not significantly deteriorate and moreover no differences between the groups were observed.During the efficacy phase,neither the placebo nor the AN-PEP group developed significant antibody titers.The IgA-EM concentrations remained negative in both groups.Two patients were excluded from entering the efficacy phase as their mucosa showed an increase oftwo Marsh steps after the safety phase,yet with undetectable se
文摘This current concepts review outlines the role of diffe-rent imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone(usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography(CT) and magnetic resonance imaging(MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available.
文摘The elbow joint is a complex joint, which, when impaired in function, leads to severe disability. In some cases however, an arthroplasty might be an appropriate treatment. In the past four decades, large steps havebeen taken to optimize this treatment in order to achieve better post-operative outcomes. To understand these progresses and to discover aspects for upcoming improvements, we present a review on the past developments, the present state of affairs and future developments which may improve patient care further.
文摘Optokinetic nystagmus (OKN) is rhythmic eye movements, back and forth, with a slow and fast phase when the eyes are presented for full-field visual stimulus. OKN was recorded in a healthy subject for four conditions, stripes moving 30<span style="white-space:nowrap;">°</span>/s left and right and 60<span style="white-space:nowrap;">°</span>/s left and right. In this paper, surrogate data analysis was applied to test the Hurst exponents for increasing time horizons for the integrated OKN amplitude sequences statistically against 100 shuffled sequences (<em>i.e.</em>, the serial dependency of the original data sequences is broken by changing the order of the sequence). The result shows that the pattern of the OKN amplitude sequence scales statistically different (<em>p</em> < 0.01) compared to random permutations of the same numbers for scaling shorter than 16 nystagmus components (slow and fast phases) for all four test conditions.
文摘Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,which can easily be overlooked on the initial standard radiographs.The treatment options for proximal radius fractures in children range from non-surgical treatment,such as immobilization alone and closed reduction followed by immobilization,to more invasive options,including closed reduction with percutaneous pinning and open reduction with internal fixation.The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient;an angulation of less than 30 degrees and translation of less than 50%is generally accepted,whereas a higher degree of displacement is considered an indication for surgical intervention.Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures,range of motion and complications compared to severely displaced fractures requiring surgical intervention.With proper management,good to excellent results are achieved in most cases,and long-term sequelae are rare.However,severe complications do occur,including radio-ulnar synostosis,osteonecrosis,rotational impairment,and premature physeal closure with a malformation of the radial head as a result,especially after more invasive procedures.Adequate follow-up is therefore warranted.
基金supported by the United States Department of Agriculture Specialty Crop Research Initiative(SCRI)2008-51180-04878(NV)grant,New Jersey Agricultural Experiment Station and Ocean Spray Cranberries,Inc.
文摘Culturable fungal population diversity and succession was investigated in developing cranberry ovaries of fruit rot-resistant and rot-susceptible cranberry selections,from flower through mature fruit.Fungi were recovered in culture from 1185 of 1338 ovary tissues collected from June to September,yielding 2255 isolates that represented 42 morphotaxa.During the season,species richness varied from 2 to 17 and 2 to 18 in rot-resistant and rotsusceptible selections,respectively,increasing from wk1 to wk10 and then gradually declining to wk14.Shannon-Wiener diversity index varied from 0.27 to 2.32 in rotresistant and 0.18 to 2.38 in rot-susceptible,and Pielou’s evenness index varied from 0.11 to 0.63 and 0.06 to 0.64 in rot-resistant and rot-susceptible selections,respectively,confirming that diversity of fungi in developing ovaries was similar among rot-resistant and rot-susceptible selections,but varied among sampling time points.Principal component analysis grouped samples collected at the same sampling time point together regardless of rot susceptibility of the selections,and detected the predominant fungal species associated with each stage of development.Successional changes were observed in populations of endophytic,pathogenic and saprophytic fungi throughout the season as ovaries matured.
基金supported in part by the New Jersey Agricultural Experiment Station and the Rutgers Turfgrass Science Center.
文摘A new Epichloëspecies distributed in Africa,Europe,North America and South America on host genera Bromus,Festuca,Lolium and Poa is described.Stromata,characteristic of the genus,frequently occurred on the reproductive tillers of Poa secunda subsp.juncifolia,but neither perithecia nor mature asci were observed.Conidiogenous cells and conidial characteristics were in the range of Epichloëtyphina.Regions of the genes encodingβ-tubulin(tub2)and translation elongation factor 1-α(tef1)were amplified and sequenced.Phylogenetic analyses of these sequences grouped the Poa secunda subsp.juncifolia endophyte into one group within a non-hybrid Epichloëspecies complex.On the basis of morphology,host range and evolutionary history we propose that this endophyte represents a new species of Epichloë.The name Epichloëpoae is proposed for this endophyte.The infectivity of the conidia produced on plants was evaluated.In the first experiment,using conidia of Epichloëpoae from leaves and endophytefree seeds of Poa secunda subsp.juncifolia we show that when germinating seeds and developing seedlings of the plant were exposed to conidia,28–57%of seedlings became infected by the endophyte.The non-inoculated control plants showed no colonization by the endophyte.In the following spring after vernalization,colonized plants on flowering culms produced stromata with conidia.In the second experiment,using stromal conidia and the same procedure,19–42%of seedlings of Poa secunda subsp.juncifolia became colonized by the endophyte.Our results demonstrate that Epichloëpoae may spread to uninfected grass hosts by conidia frequently formed on the surfaces of plant leaves as well as by conidia formed on stromata.
文摘Macrophages play an important role in immunity and homeostasis. Upon pathogen recognition via specific receptors, they rapidly induce inflammatory responses. This process is tightly controlled at the transcriptional level. The DNA binding zinc-finger protein CCCTC-binding factor （Ctcf） is a crucial regulator of long-range chromatin interactions and coordinates specific communication between transcription factors and gene expression processes. In this study, the Ctcf gene was specifically deleted in myeloid cells by making use of the transgenic Cre-LoxP system. Conditional deletion of the Ctcfgene in myeloid cells induced a mild phenotype in vivo. Ctcf-deficient mice exhibited significantly reduced expression of major histocompatibility complex （MHC） class II in the liver. Ctcf-deficient macrophages demonstrated a normal surface phenotype and phagocytosis capacity. Upon Toll-like receptor （TLR） stimulation, they produced normal levels of the pro-inflammatory cytokines IL-12 and IL-6, but manifested a strongly impaired capacity to produce tumor-necrosis factor （TNF） and IL-IO, as well as to express the IL-IO family members IL-19, IL-20 and IL-24. Taken together, our data demonstrate a role of Ctcf that involves fine-tuning of macrophage function.
文摘Acute septic arthritis in children is an orthopaedic emergency.A delay in diagnosis and inappropriate treatment can result in devastating damage to the joint with lifelong disability as a consequence.The clinical presentation can be a diagnostic challenge,especially in young children.A recent systematic review showed that joint tenderness and fever are important signals of septic arthritis.Ultrasound is helpful in detecting the presence of a joint effusion.Plain radiographs may show bone changes but magnetic resonance imaging is the most reliable imaging study for detecting concomitant osteomyelitis.The diagnosis of acute septic arthritis is highly suggestive when pus is aspirated from the joint,in case of a positive culture or a positive gram stain of the joint fluid,or if there is a white blood-cell count in the joint fluid of more than 50000/mm3.Staphylococcus aureus is the most commonly cultured organism.Recent systematic reviews have identified the most effective drainage techniques,including needle aspiration,arthroscopy and arthrotomy,depending on the affected joint.After the drainage procedure it is important to monitor the clinical and laboratory outcomes.Additional drainage procedures may be necessary in select cases.
