Human cytomegalovirus (CMV) is a ubiquitous Herpesviridae virus with a wide spectrum of pathology in humans. Host immunity is a major determinant of the clinical manifestation of CMV and can vary widely in the gastroenterology and hepatology practice setting. Immunocompetent patients generally develop a benign, self-limited mononucleosis-like syndrome whereas gastrointestinal tissue-invasive disease is more frequently seen in immunocompromised and inflammatory bowel disease patients. Additionally, liver allograft dysfunction is a significant consequence of CMV infection in liver transplant patients. While polymerase chain reaction and immunohistochemistry techniques allow for the reliable and accurate detection of CMV in the human host, the diagnostic value of different serologic, endoscopic, and histologic tests depends on a variety of factors. Similarly, latent CMV, CMV infection, and CMV disease carry different significance depending on the patient population, and the decision to initiate antiviral therapy can be complex and patient-specific. This review will focus on the pathophysiology, diagnosis, and management of CMV in patient populations relevant to the practice of gastroenterology and hepatology—liver transplant recipients, inflammatory bowel disease patients, and otherwise immunocompetent patients.
A variational volume-of-fluid (VVOF) methodology for evolving interfaces under curvature-dependent speed is devised. The interface is reconstructed geometrically using the analytic relations of Scardovelli and Zaleski [1] and the advection of the volume fraction is performed using the algorithm of Weymouth and Yue (WY) [2] with a technique to incorporate a volume conservation constraint. The proposed approach has the advantage of simple implementation and straightforward extension to more complex systems. Canonical curves and surfaces traditionally investigated by the level set (LS) method are tested with the VVOF approach and results are compared with existing work in LS.
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