oxysporum and nisin did not inhibit the growth of Gram-negative b

oxysporum and nisin did not inhibit the growth of Gram-negative bacteria (E. coli, S. enteritidis, and P. vulgaris). The relative inhibition times of CS-40/nisin solutions with different concentrations and TPCA-1 purchase ratios of CS-40 and nisin were also investigated against the seven microorganisms. The results showed that CS-40/nisin solutions with CS-40/nisin concentration ratios of 0.05/0.005, 0.05/0.0025, 0.05/0.00125, and 0.025/0.0001% had higher antimicrobial activity against all tested bacteria and fungi. The relationship between complex formation and antimicrobial activity is discussed. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 116: 3702-3707, 2010″
“The coherent transport properties

of armchair graphene nanoconstrictions (GNC) are studied using tight-binding approach and Green’s function method. We find a nonbonding state at zero Fermi energy which results in a zero conductance valley, when a single vacancy locates at y=3n+1 of a perfect metallic armchair graphene

nanoribbon (aGNR). However, the nonbonding state does not exist when a vacancy locates at y=3n, and the conductance behavior of lowest conducting channel will not be affected by the vacancy. For the square-shaped armchair GNC consisting of three metallic aGNR segments, resonant tunneling behavior is observed in the single channel energy region. We find that the Selleck WH-4-023 presence of localized edge state locating at the zigzag boundary can affect the resonant tunneling severely. A simplified one dimensional model is put forward at last, which explains the resonant tunneling behavior of armchair GNC very well. (C) 2010 American Institute of Physics. [doi:10.1063/1.3391273]“
“Objective The aim of the study was to analyse the health-related quality of life (HRQoL) in Polish children with chronic kidney disease (CKD) dependant on the CKD stage, treatment modality and selected social life elements in families of the patients. Furthermore, potential differences between self-report and

parent/proxy reports and the factors influencing them were assessed.

Methods A total of 203 CKD children (on haemodialysis (HD), peritoneal dialysis (PD) and conservative treatment (CT)) and their 388 parent/proxies PD98059 chemical structure were enrolled into a cross-sectional national study. The demographic and social data were evaluated. We used the Paediatric Quality of Life Inventory 4.0 Generic Core Scales to assess the HRQoL in children.

Results Health-related quality of life scores for all CKD groups were significantly lower in all domains compared with population norms, the lowest one being in the HD group. In CT children, HRQoL did not depend on the CKD stage. Both parents assessed the HRQoL of their children differently depending on their involvement in the care. There are differences between the HRQoL scores of the children and their parents.

Results: After performing paired samples t-test of doses based on

Results: After performing paired samples t-test of doses based on the physician group with those based on the computer system (mean -1.5654 +/- 2.09), a statistically significant difference was found (p < 0.015). Furthermore, the patients kept at TTR by physicians amounted to 26 % compared to 70 % by the software.

Conclusion: The difference between TTR managed by physicians and those managed BEZ235 cell line using CoagClinic (TM) software is statistically significant. It appears that the software improves the effectiveness of warfarin dosing in patients.”
“Hypothesis:

Type II collagen is synthesized in the tympanic membrane during healing of a perforation. The time course and appearance of Type II collagen regrowth in the newly healed

tympanic membrane is the subject of the present study.

Background: The arrangement of Type II collagen fibers in the tympanic membrane gives it a unique tensile strength important for sound conduction. Healing after tympanic membrane https://www.selleckchem.com/products/VX-809.html perforation can cause the tympanic membrane to lose its characteristic. At what phase Type II collagen in tympanic membrane is replaced during healing of a perforation has previously not been studied.

Methods: Rat tympanic membranes were perforated, and the animals were sacrificed 9 to 16 days after perforation. Tympanic membranes were stained with a Type II collagen antibody.

Results: At Day 9, a majority of the tympanic membranes had healed. Keratinizing epithelium and connective tissue had formed,

but there was no Type II collagen. At Day 10, all tympanic membranes had healed, and staining for Type II collagen appeared. After Day 10, staining was more intense. Newly formed collagen did not show the parallel bundle arrangement seen in normal tympanic membranes but was more scattered in the tissue.

Conclusion: Type II collagen was seen in tympanic membranes only after closure of the perforation. The fiber arrangement after healing was disturbed, which presumably has an impact on the function of the tympanic membrane. Understanding www.selleckchem.com/products/ro-3306.html the formation of Type II collagen in the healing of tympanic membrane perforations could enable further research toward treating tympanic membrane perforations.”
“This study determined the prevalence of metallo-beta-lactamase (MBL)-producing Pseudomonas aeruginosa in two hospitals located in the Southern part of Brazil and compare the performance of two different phenotypic tests. Thirty-one non-repetitive Pseudomonas aeruginosa isolates from various clinical samples from patients admitted to two hospitals located in Rio Grande do Sul, Brazil (twenty-three from a hospital in Porto Alegre City and eight isolates from a hospital in Vale dos Sinos Region). All strains suggestive of possessing MBLs by phenotypic methods were included in this study.

purpurea and Cephalaria davisiana) was investigated The essentia

purpurea and Cephalaria davisiana) was investigated. The essential oil mixtures were

obtained by steam distillation in a Clevenger-type apparatus. Twenty-eight components were identified by GC-FID and GC-MS techniques. While total volatile percentages ranged from 68.99% to 84.57%, BLZ945 in vitro the total essential oil yields ranged between 38.15% and 64.05%. Geraniol, -cedrene and p-cymene were determined as the main components. Geraniol was detected as a major component in C. cilicica (14.64%), and -cedrene was detected as a major component with 26.03% for C. lycica, 16.93% for C. scoparia, 13.01% for C. davisiana and 10.94% for C. paphlagonica. Cephalaria scoparia, C. davisiana and C. gazipashensis have considerable amount of p-cymene as 12.86%, 12.70% and 11.16%, respectively. This was the first essential oil report concerning the Cephalaria genus.”
“Background: Drug-related negative outcomes (DNOs) are health problems that patients experience due to drug use or nonuse. Heart failure (HF) patients are at high risk of experiencing DNOs owing to polypharmacy,

comorbidities, and age.

Methods and Results: Ninety-seven consecutive HF patients were enrolled and followed for 6 months. A pharmacist, integrated within a multidisciplinary HF team, reviewed the medication of each patient to detect, resolve, and/or prevent possible DNOs, risks of developing a DNO (rDNOs) and the drug-related problems (DRPs) that are associated with them. We detected 147 DNOs/rDNOs with

a mean of 1.5 +/- 1.4 per patient. Among DNOs, 45% were due to a lack of a pharmacologic treatment (need for a drug) and Selleckchem JNK-IN-8 24% were treatments with an insufficient drug dose (quantitative ineffectiveness). Among rDNOs, 33% were due to use of an unsafe drug (nonquantitative Selleckchem MK 2206 lack of safety) and 30% to quantitative ineffectiveness. Ninety-four percent of DNOs/rDNOs were preventable, and, importantly, 5.5% were classified as clinically serious. During follow-up, pharmacist interventions solved or prevented the health problem in 83% of cases. The most frequently identified DRPs were “”insufficiently treated health problem”" (31%), “”inadequate dose, regimen, or duration of a drug”" (22%), “”probability of adverse effects”" (16%), and “”nonadherence”" (14%). A significant relationship between the number of DNOs/rDNOs and the number of drugs was found (P < .013).

Conclusions: Chronic HF outpatients have a high incidence of preventable DNOs. The inclusion of a pharmacist in multidisciplinary HF teams should be considered, because it is clinically beneficial for patients and it increases HF specialists’ awareness of DNO, especially those beyond HF. (J Cardiac Fail 2011;17:217-223)”
“A comparative first principles study has been carried out for EuLiH(3) (ELH) and EuTiO(3) (ETO) using the generalized gradient approximation +U approach.

In this study, rotavirus CC0812-1 was purified from the culture s

In this study, rotavirus CC0812-1 was purified from the culture supernatant of CC0812-1-infected MA104 cells and used as antigen to immunize BALB/c mice. Four hybridoma clones were developed secreting antibodies that reacted with CC0812-1, designated as 1B1, 1B8, 1F11, and 1G10, respectively. Western blot analysis indicated that the four monoclonal antibodies (MAbs) were all specific for VP4 of rotavirus CC0812-1. Isotyping revealed that MAbs 1B1, 1B8, and 1G10 belonged to the IgM class, while MAb 1F11 belonged to the IgG1 subclass. A neutralization test demonstrated that the four MAbs all had the capacity to neutralize rotavirus this website CC0812-1. The neutralizing

titers of the BALB/c mice ascites were 1:2048, 1:1024, 1:512, and 1:512 for MAbs 1B1, 1B8, 1F11, and 1G10, respectively.”
“Objective: To examine effects of high omega-3 (n-3) polyunsaturated fatty acid (PUFA) diets on development of osteoarthritis (OA) in a spontaneous guinea pig model, and to further characterise pathogenesis in this model. Modern diets low in n-3 PUFAs have been linked with increases in inflammatory disorders, possibly including OA. However,

n-3 is also thought to increases bone density, which is a possible contributing factor in OA. Therefore we aim to determine the net influence of n-3 in disease development.

Method: OA-prone Dunkin-Hartley (DH) Guinea pigs were compared with OA-resistant Bristol Strain-2s (BS2) each fed a standard or learn more an n-3 diet from 10 to 30 weeks (10/group). We examined cartilage and subchondral bone pathology by histology, and biochemistry, including collagen cross-links, matrix metalloproteinases (MMPs), alkaline phosphatase, glycosaminoglycan (GAG), and denatured type II collagen.

Results:

Dietary n-3 reduced disease in OA-prone animals. Most cartilage parameters were modified by n-3 diet towards those seen in the non-pathological BS2 strain – significantly active MMP-2, lysyl-pyridinoline and total collagen cross-links – the only exception being pro MMP-9 which was lower in the BS2, yet increased with n-3. GAG content was BI 6727 in vitro higher and denatured type II lower in the n-3 group. Subchondral bone parameters in the DH n-3 group also changed towards those seen in the non-pathological strain, significantly calcium:phosphate ratios and epiphyseal bone density.

Conclusion: Dietary n-3 PUFA reduced OA in the prone strain, and most disease markers were modified towards those of the non-OA strain, though not all significantly so. Omega-3 did not increase markers of pathology in either strain. (C) 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.”
“OBJECTIVE: Nitric oxide is produced by endothelial nitric oxide synthase, and its production can be influenced by polymorphisms of the endothelial nitric oxide synthase gene.

The strain field measured from the analysis of R lines has been f

The strain field measured from the analysis of R lines has been found to be erased at the same time when the reversible centers are recombined (similar

to 1100 selleck kinase inhibitor degrees C). This fact seems to indicate that these defects act as pinning centers for the induced stress. Furthermore, we have found that the waveguide generated in the proximity of the filament disappear for annealing temperatures above 1100 degrees C. This clearly supports the assumption that waveguiding is produced by the strain stress induced refractive index increment based on the dominant electronic polarizability enhancement.”
“Objective. The objective of this study was to assess the accuracy and reproducibility of cone-beam CT measurements of specific distances around the mandibular canal by comparing them

to direct digital caliper measurements.

Methods. Six formalin-fixed hemimandible specimens were examined using the ILUMA cone-beam CT system. Images were obtained at 120 kVp, 3.8 mA, and a voxel size of 0.2 mm, with an exposure time of 40 seconds. Specimens were cut into sections at 7 locations using a Lindemann burr, and a digital caliper was used to measure the following distances on both the anterior and posterior sides of each section: Mandibular Width (W); Mandibular Length (L); Upper Distance (UD); Lower Distance (LD); Buccal Distance (BD); and Lingual Distance (LID). The same distances were measured on the corresponding cross-sectional cone-beam Ferroptosis inhibitor CT images using the built-in measurement software. All caliper and cone-beam CT measurements were made by 2 independent trained observers and were repeated after an interval of 1 week. The Bland/Altman method was used to calculate intra- and inter-rater reliability. Intra-class correlation coefficients (ICCs) from 2-way random effects model were calculated. Agreements between cone-beam CT and direct digital caliper were calculated by ICC for 6 distances and 2 observers.

Results. Intraobserver and interobserver measurements for all distances showed high agreement. ICCs for intraobserver agreement ranged from 0.86 SNX-5422 to 0.97 for cone-beam CT measurements and from 0.98 to 0.99

for digital caliper measurements. ICCs between observers ranged from 0.84 to 0.97 for the cone-beam CT measurements and from 0.78 to 0.97 for the digital caliper measurements. ICCs for cone-beam CT and direct digital caliper ranged from 0.61 to 0.93 for the first observer and from 0.40 to 0.95 for the second observer.

Conclusion. Accuracy of cone-beam CT measurements of various distances surrounding the mandibular canal was comparable to that of digital caliper measurements. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: e34-e42)”
“Chronic obstructive pulmonary disease (COPD) is a multifactorial disease with possible genetic predisposition and involvement of various environmental factors. Several candidate genes have been reported as potentially associated with this lung disease.

Experimental results showed that the unique properties of NaCS-PD

Experimental results showed that the unique properties of NaCS-PDMDAAC capsules, such as pore size, capsule size, mechanical strength, and structural and compositional homogeneity, relevant to microalgae cultivation with batch or continuous nutrient removal can be accurately controlled. CONCLUSION: These polymeric Selleck IBET762 capsules find applications not only with microalgae cultivation but also for other microorganisms. (c) 2012 Society of Chemical Industry”
“The analytical

estimates for the relaxation time of a single-domain particle with a nonaxially symmetric double-well potential are obtained in the limits of low and high dissipation regimes. The expressions derived turn out to be valid also for an important LDC000067 solubility dmso case of spheroidal nanoparticle whose easy anisotropy axis is inclined at an arbitrary angle to a shape anisotropy axis. The analytical estimates are compared with the numerical simulation results obtained for the same particle by means of solution of the stochastic Landau-Lifshitz equation at various values of the dimensionless damping parameter kappa. It is shown that in the case of moderate reduced energy barrier the high damping limit occurs

at kappa >= 1.0, whereas the low damping limit corresponds to very small values of the damping parameter, kappa <= 0.003. For intermediate values of kappa, a heuristic interpolation formula for the particle relaxation time is suggested. It describes the numerical simulation results with accuracy of several percent.”
“BACKGROUND:

The applicability of biosorption for the treatment of metal plating wastewater is adversely affected by the presence of complexing agents. To investigate this limitation on the removal of copper(II) onto peat, batch and column experiments were carried out using EDTA as the model complexing agent. The influence of pH and copper(II):EDTA Bcl-2 inhibitor mass ratios were evaluated for copper(II) concentrations between 5 and 100 mg Cu(II) dm3. RESULTS: EDTA negatively affected the copper(II) uptake of peat for pH > 5. Batch and column experiments showed that copper(II)-EDTA complexes were not sorbed by peat. The leaks of copper(II) detected from the beginning of the column operation matched the copper(II)-EDTA concentration in the feed solutions. To overcome the interference of EDTA, a novel approach based on the combination of peat + activated carbon was proposed. Nearly complete removal of copper(II) was maintained over 70 h in the treatment of a solution containing 20 mg Cu(II) dm3 with 11% of copper(II)-EDTA complexes.

Knowledge of co-existing conditions or patient characteristics th

Knowledge of co-existing conditions or patient characteristics that lead to an increased QOL decline is important for individual

care, and for public health purposes. In visually impaired older adults, it remains unclear which co-existing conditions or other characteristics Selleck Bucladesine influence their health-related QOL. Our aim was to present a risk profile of characteristics and conditions which predict deterioration of QOL in visually impaired older patients.

Methods: Analyses were performed on data from an observational study among 296 visually impaired older patients from four Dutch hospitals. QOL was measured with the EuroQol-5D (EQ-5D) at baseline and at five-month follow-up. Nine co-existing condition categories (musculoskeletal; diabetes; heart; hypertension; chronic obstructive pulmonary disease (COPD) or asthma; hearing impairment; stroke; cancer; gastrointestinal conditions) and six patient characteristics (age; gender; visual acuity; click here social status; independent living; rehabilitation type) were tested in a linear regression model to determine the risk profile. The model

was corrected for baseline EQ-5D scores. In addition, baseline EQ-5D scores were compared with reference scores from a younger visually impaired population and from elderly in the general population.

Results: From the 296 patients, 50 (16.9%) were lost to follow-up. Patients who reported diabetes, COPD or asthma, consequences of stroke, musculoskeletal conditions, cancer, gastrointestinal conditions or higher logMAR Visual Acuity values, experienced a lower QOL. After five months, visual acuity, musculoskeletal conditions, COPD/asthma and stroke predicted a decline in QOL (R(2) = 0.20). At baseline, the visually impaired older patients more often reported moderate or severe problems on most EQ-5D dimensions than the two reference groups.

Conclusion: In visually impaired older patients, visual acuity, musculoskeletal conditions, COPD/asthma and stroke predicted a relatively rapid MEK inhibitor decline in health-related QOL. With this risk profile, a specific referral by the ophthalmologist to another sub-specialty may have

a beneficial effect on the patient’s health-related QOL. A referral by the ophthalmologist or optometrist to a multidisciplinary rehabilitation service seems appropriate for some patients with co-morbidity. The current results need to be confirmed in studies using pre-structured questionnaires to assess comorbidity.”
“Two new discovered C-geranylated flavonoids tomentomimulol (1) and mimulone B (2) were isolated from the methanol extract of Paulownia tomentosa (Thunb). Steud. (Paulowniaceae) fruits by exhaustive chromatographic separation together with one known compound tanariflavanone D (3). The identification of compounds and structure elucidation was carried out using 1D and 2D NMR experiments, as well as mass spectroscopy, ultra-violet, infra red and CD experiments.

At the clinical level, the pattern of polydrug consumption is a p

At the clinical level, the pattern of polydrug consumption is a phenomenon of considerable frequency. Finally, as a complement at the end, an updated summary is included about the role of glutamate in other neuropsychiatric disorders (for example, mood disorders, schizophrenia, and others).”
“To compare Endothelin (ET) production and genes expression

of ET-1 and ET(A) receptor (ET(A)R) between broiler and layer chickens during rearing, semi-quantitative RT-PCR and enzyme immunometric assay were performed in the heart ventricles and serum. There were gradual elevations of ET-1 and ET(A)R mRNAs in the left ventricle of broiler and layer chicken groups that were mainly significant (P < 0.05) at 28, 35 and 42 days of age with compared to previous days whereas were not significant between two groups.

These gradual elevations of ET-1 and ET(A)R mRNAs were also observed in selleck compound the right ventricle that

BTSA1 price were significant (P < 0.05) at 28,35 and 42 days of age in broilers and 42 days of age in layers with compared to previous days. Increasing of these mRNAs in the right ventricle of broiler chickens were significantly (P < 0.05) more than layer chickens at 28, 35 and 42 days. Serum ET in broilers was significantly (P < 0.05) higher than layer chickens at 28 and 42 days of age. It is concluded that circulating ET and cardiac ET-1, ET(A)R genes expression is higher in broiler chickens than in layer chickens particularly after 21 days of age. It is probably that these breed differences make broiler chickens to be more susceptible to Endothelin related-cardiomyopathies such as congestive heart failure and ascites. (C) 2010 Elsevier Ltd. All rights reserved.”
“Magnetic nanowires could be the building bricks in the fabrication of composite magnetic materials because of their large intrinsic shape anisotropy.

We investigate the relation between the detailed shape of a magnetic nanowire and its magnetic coercivity. We have performed three-dimensional micromagnetic simulations on various types of nanowires synthesized during the past few years such as cylinders, dumbbells, or diabolos. The calculations, performed on individual model objects, show that the selleckchem wire tip plays a key role in the reversal mechanism and on the magnitude of the coercive field and that the aspect ratio plays a much lesser role. Ellipsoidal or cylindrical shapes favor a coherent rotation of the magnetization and thus large coercive fields. Complex tip shapes act as nucleation points and significantly reduce the coercive field. Thus, in order to optimize the shape of magnetic nanowires for permanent magnet applications, the focus should be put on the detailed shape of the wire tips and thus on the growth mechanism rather than on the aspect ratio.

Aux/IAA genes encode short-lived transcriptional regulators centr

Aux/IAA genes encode short-lived transcriptional regulators central to the control of auxin responses. Their functions have been defined primarily by dominant, gain-of-function mutant alleles in Arabidopsis. The Sl-IAA3 gene encodes a nuclear-targeted protein that can repress transcription from auxin-responsive promoters. Sl-IAA3 expression is auxin and ethylene dependent, is regulated on a tight tissue-specific basis, and is associated with tissues undergoing differential growth such as in epinastic petioles and apical hook. Antisense down-regulation of Sl-IAA3 results in auxin

and ethylene-related phenotypes, including altered apical dominance, lower auxin sensitivity, exaggerated apical hook curvature in the Staurosporine chemical structure dark and reduced petiole epinasty in the light. The results provide novel insights into the roles of Aux/IAAs and position the Sl-IAA3 protein at the crossroads of auxin and ethylene signalling in tomato.”
“Background The aims of this study were to explore health-related quality of life (HRQOL) in patients with hepatocellular carcinoma (HCC). We report the following: (1) differences in HRQOL between patients

with HCC and the general population; (2) significant selleck chemical physical and psychological predictors of HRQOL; and (3) mediation effects of illness perceptions and coping on HRQOL. Methods Patients with HCC (n=286) from Taiwan completed standardized measures of HRQOL, illness perception (cognitive representations, emotional representations and GSK2126458 supplier illness comprehensibility) and coping (emotion-oriented and problem-orientation coping). Demographic and physical variables were also collected. Results Patients with HCC had worse global HRQOL, physical, role, cognitive and social functioning, but better emotional functioning than the general population. Physical variables and cognitive representation were significant predictors of global HRQOL, physical functioning and emotional functioning. Cognitive

representation mediated the relationships between physical variables and global HRQOL, physical functioning and emotional functioning, but coping only mediated the relationship between cognitive representation and global HRQOL. Conclusions The results suggest that physical variables have direct effects on global HRQOL and physical functioning, but there were also partial mediations through cognitive representation. The effect of physical variables on emotional functioning was mediated through cognitive and emotional representations. Patients with better performance status and positive illness perceptions tended to report better HRQOL, but those with negative illness perceptions and who used more emotion-oriented coping had worse HRQOL. Limitations of the work associated with use of theory and measures developed in Europe and the US are discussed, as are the clinical implications for patients with HCC. Copyright (c) 2012 John Wiley & Sons, Ltd.

The structure

The structure https://www.selleckchem.com/products/MK-2206.html and function of the C/EBP(3 gene and the related protein isoforms are discussed along with the transcription factors, coactivators, viral proteins, cytokines and chemokines that affect C/EBP function.”
“The pathogenesis of hepatitis B

virus (HBV) is complex and it appears that molecular variants play a role in this process. HBV undergoes numerous rounds of error prone production within an infected host. The resulting quasispecies are heterogeneous and in the absence of archaeological records of past infection, the evolution of HBV can only be inferred indirectly from its epidemiology and by genetic analysis. This review gathered the controversies about the HBV origin and factors influencing its quasispecies. Also, it provided some evidence on how HBV genotypes correlated with human history and patterns of migration. It is our belief that this topic deserves further attention and thus it is likely that more critical research work will be performed to elucidate the unknown mechanisms and processes in

this area.”
“Study Design. Case report.

Objective. We report a case of primary intradural extramedullary melanoma of the cervical spinal cord in a nonwhite patient.

Summary of Background Data. Melanoma occurs most commonly in white populations and is rare in Asian populations. Primary malignant melanoma BAY 80-6946 of the spinal cord is a rare disease entity that predominately affects the middle or lower thoracic spine.

Methods. A 39-year-old man presented with a tingling sensation in the upper extremities accompanied by motor weakness of the lower extremities. Preoperative magnetic resonance imaging (MRI) of the cervical spine suggested a multiloculated subdural hematoma in the subacute stage that spread from the level of C1 to the level of C6.

Results. A standard posterior midline approach was used under the impression that the subacute subdural hematoma was EX 527 caused by a

hidden vascular anomaly or a rare, intradural, pigmented tumor. A dark black-colored, hard, intradural mass was found, and gross total removal was performed. Histopathological investigation confirmed malignant melanoma. No hypermetabolic lesions were noted on whole-body FDG-PET. Additional dermatologic and ophthalmologic examinations did not reveal any other foci of primary melanoma. The patient was discharged with improvement of motor weakness. Subsequent radiotherapy and chemotherapy were administered.

Conclusion. Unlike most cases of primary intradural melanoma, this patient presented with unusual radiologic findings in the cervical spinal cord. The case described in the present study illustrates that primary spinal cord melanoma is rare and must be diagnosed with caution due to its variable clinical and radiologic presentation.