Left paratesticular mass mimicking polyorchidism: A case report

We report a rare case of primary scrotal lipoma in a 20-year-old patient which clinically mimics a left triorchidism. The patients presented with the left testicular swelling and the ultrasonography of the scrotum revealed an inhomogeneous hyperechoic mass with an inconclusive report. The left scrotal hemi exploration was planned, and intraoperatively, it was found to be a paratesticular mass with an equivalent size corresponding to the left testicle, separate from the left testicle. The histopathology confirms the lipomatous swelling. The post-operative period remains uneventful and the patient has been on follow-up for the past 1 year with no relapse

Mucus-penetrating nonviral gene vaccine processed in the epithelium for inducing advanced vaginal mucosal immune responses

Establishment of vaginal immune defenses at the mucosal interface layer through gene vaccines promise to prevent infectious diseases among females. Mucosal barriers composed of a flowing mucus hydrogel and tightly conjugated epithelial cells (ECs), which represent the main technical difficulties for vaccine development, reside in the harsh, acidic human vaginal environment. Different from frequently employed viral vectors, two types of nonviral nanocarriers were designed to concurrently overcome the barriers and induce immune responses. Differing design concepts include the charge-reversal property (DRLS) to mimic a virus that uses any cells as factories, as well as the addition of a hyaluronic acid coating (HA/RLS) to directly target dendritic cells (DCs). With a suitable size and electrostatic neutrality, these two nanoparticles penetrate a mucus hydrogel with similar diffusivity. The DRLS system expressed a higher level of the carried human papillomavirus type 16 L1 gene compared to HA/RLS in vivo. Therefore it induced more robust mucosal, cellular, and humoral immune responses. Moreover, the DLRS applied to intravaginal immunization induced high IgA levels compared with intramuscularly injected DNA (naked), indicating timely protection against pathogens at the mucus layer. These findings also offer important approaches for the design and fabrication of nonviral gene vaccines in other mucosal systems.

The Effects of Meal Timing and Frequency, Caloric Restriction, and Fasting on Cardiovascular Health: an Overview

Cardiovascular disease (CVD), which is the leading cause of death worldwide, is strongly affected by diet. Diet can affect CVD directly by modulating the composition of vascular plaques, and indirectly by affecting the rate of aging. This review summarizes research on the relationships of fasting, meal timing, and meal frequency with CVD incidence and progression. Relevant basic research studies, epidemiological studies, and clinical studies are highlighted. In particular, we discuss both intermittent and periodic fasting interventions with the potential to prevent and treat CVD.

Effects of nanofibers on mesenchymal stem cells: environmental factors affecting cell adhesion and osteogenic differentiation and their mechanisms / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Nanofibers can mimic natural tissue structure by creating a more suitable environment for cells to grow, prompting a wide application of nanofiber materials. In this review, we include relevant studies and characterize the effect of nanofibers on mesenchymal stem cells, as well as factors that affect cell adhesion and osteogenic differentiation. We hypothesize that the process of bone regeneration in vitro is similar to bone formation and healing in vivo, and the closer nanofibers or nanofibrous scaffolds are to natural bone tissue, the better the bone regeneration process will be. In general, cells cultured on nanofibers have a similar gene expression pattern and osteogenic behavior as cells induced by osteogenic supplements in vitro. Genes involved in cell adhesion (focal adhesion kinase (FAK)), cytoskeletal organization, and osteogenic pathways (transforming growth factor-β (TGF-β)/bone morphogenic protein (BMP), mitogen-activated protein kinase (MAPK), and Wnt) are upregulated successively. Cell adhesion and osteogenesis may be influenced by several factors. Nanofibers possess certain physical properties including favorable hydrophilicity, porosity, and swelling properties that promote cell adhesion and growth. Moreover, nanofiber stiffness plays a vital role in cell fate, as cell recruitment for osteogenesis tends to be better on stiffer scaffolds, with associated signaling pathways of integrin and Yes-associated protein (YAP)/transcriptional co-activator with PDZ-binding motif (TAZ). Also, hierarchically aligned nanofibers, as well as their combination with functional additives (growth factors, HA particles, etc.), contribute to osteogenesis and bone regeneration. In summary, previous studies have indicated that upon sensing the stiffness of the nanofibrous environment as well as its other characteristics, stem cells change their shape and tension accordingly, regulating downstream pathways followed by adhesion to nanofibers to contribute to osteogenesis. However, additional experiments are needed to identify major signaling pathways in the bone regeneration process, and also to fully investigate its supportive role in fabricating or designing the optimum tissue-mimicking nanofibrous scaffolds.

Effects of nanofibers on mesenchymal stem cells: environmental factors affecting cell adhesion and osteogenic differentiation and their mechanisms / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Nanofibers can mimic natural tissue structure by creating a more suitable environment for cells to grow, prompting a wide application of nanofiber materials. In this review, we include relevant studies and characterize the effect of nanofibers on mesenchymal stem cells, as well as factors that affect cell adhesion and osteogenic differentiation. We hypothesize that the process of bone regeneration in vitro is similar to bone formation and healing in vivo, and the closer nanofibers or nanofibrous scaffolds are to natural bone tissue, the better the bone regeneration process will be. In general, cells cultured on nanofibers have a similar gene expression pattern and osteogenic behavior as cells induced by osteogenic supplements in vitro. Genes involved in cell adhesion (focal adhesion kinase (FAK)), cytoskeletal organization, and osteogenic pathways (transforming growth factor-β (TGF-β)/bone morphogenic protein (BMP), mitogen-activated protein kinase (MAPK), and Wnt) are upregulated successively. Cell adhesion and osteogenesis may be influenced by several factors. Nanofibers possess certain physical properties including favorable hydrophilicity, porosity, and swelling properties that promote cell adhesion and growth. Moreover, nanofiber stiffness plays a vital role in cell fate, as cell recruitment for osteogenesis tends to be better on stiffer scaffolds, with associated signaling pathways of integrin and Yes-associated protein (YAP)/transcriptional co-activator with PDZ-binding motif (TAZ). Also, hierarchically aligned nanofibers, as well as their combination with functional additives (growth factors, HA particles, etc.), contribute to osteogenesis and bone regeneration. In summary, previous studies have indicated that upon sensing the stiffness of the nanofibrous environment as well as its other characteristics, stem cells change their shape and tension accordingly, regulating downstream pathways followed by adhesion to nanofibers to contribute to osteogenesis. However, additional experiments are needed to identify major signaling pathways in the bone regeneration process, and also to fully investigate its supportive role in fabricating or designing the optimum tissue-mimicking nanofibrous scaffolds.

Childhood Sarcoidosis mimicking tuberculosis: a case report

Abstract Sarcoidosis is a rare multisystem chronic inflammatory disease in children. We present a case of a five-year-old child with clinical features mimicking several diseases, including tuberculosis. After failure of treatment based on the suspected diagnosis, an axillary lymph node biopsy showed noncaseating granulomas compatible with sarcoidosis and appropriate treatment was then started.

Experimental study on the prevention of bone loss by deferoxamine in type 1 diabetic mice with osteoporosis / 中华内分泌代谢杂志

Objective To observe the effect of a hypoxia mimicking agent deferoxamine (DFO) on the mineral density,volume,architecture,strength,and metabolism of the bones in type 1 diabetic mice withosteoporosis.Methods Type 1 diabetic mice model was established by intraperitoneal injections of streptozotocin.The mice were divided into control (normal mice),diabetes mellitus,and DFO groups.Micro-CT was used to analyze the bone mineral density,volume,architecture,and strength of the trabecule in the distal part of femurs.Three point bending test was carried out to evaluate the bone strength.Hematoxylin and eosin (HE) staining was performed to observe the alteration in the number of osteoblasts.Real-time PCR was used to detect the mRNA expressions of Runt-related gene 2 (Runx-2),osteoclacin,and tartrate resistant acid phosphatase (TRAP) in tibias.Western blot was used to detect the protein expressions of Hypoxia-inducible factor-1α(HIF-1α) and vascular endothelial growth factor (VEGF) in tibias.Results There was a decrease in mineral density,volume,strength of bones as well as deteriorated trabecular microarchitecture in diabetic mice as compared to control mice,which were partially improved by DFO treatment.Moreover,DFO treatment increased the number of osteoblasts and mRNA expression levels of Runx-2,osteoclacin,TRAP,as well as protein expression levels of HIF-1 α and VEGF(P＜0.05).Conclusion Bone loss could be partially prevented by DFO treatment in type 1 diabetic osteoporosis mice,which might be ascribed to increased bone formation via stimulating hypoxia inducible factor singnaling pathway.

Platelet membrane-based and tumor-associated platelettargeted drug delivery systems for cancer therapy / 医学前沿

Platelets have long been known to play critical roles in hemostasis by clumping and clotting blood vessel injuries. Recent experimental evidence strongly indicates that platelets can also interact with tumor cells by direct binding or secreting cytokines. For example, platelets have been shown to protect circulating cancer cells in blood circulation and to promote tumor metastasis. In-depth understanding of the role of platelets in cancer progression and metastasis provides promising approaches for platelet biomimetic drug delivery systems and functional platelet-targeting strategies for effective cancer treatment. This review highlights recent progresses in platelet membrane-based drug delivery and unique strategies that target tumor-associated platelets for cancer therapy. The paper also discusses future development opportunities and challenges encountered for clinical translation.

Application Status and Progress of Mimicking Moxibustion in Clinical Trials of Moxibustion / 世界科学技术-中医药现代化

In recent years, with the widespread clinical application of moxibustion, the clinical trials on moxibustion research are also increasing. However, the establishment of negative control of moxibustion, also called as mimicking moxibustion, has become a major challenge in the randomized controlled trials (RCTs) . In this review, we summarized the establishment methods of mimicking moxibustion in RCTs at home and abroad, and evaluated and elaborated the design and application methods of mimicking moxibustion models from thermal effect, light radiation effect and smoke effect that generated by moxibustion, in order to provide insights for the establishment of an ideal and feasible mimicking moxibustion model in future RCTs of moxibustion.

Identification of anti-C alloantibodies accompanying anti-e autoantibodies / 中国输血杂志

Objective To confirm the specificity of antibodies recently found in a hospitalized patient.Methods Methods including antibody screening,antibodies identification,alloantibody titers,isolation of red blood cells by high speed capillary centrifugation and determination of Rh phenotype were employed to investigate the characteristics of antibodies.Results Anti-C alloantibody and anti-e autoantibodies were detected in the patient.Autoantibodies were non-specific in the early stages,and gradually changed into specific auti-e antibodies.The titers of anti-C alloantibody were always lower than 4.Conclusion The identification of antibodies should be integrated as far as possible in various aspects of methodology.

Antibodies identification and crossmatching of a case with alloanti-C, e combing autoantibody mimicking alloanti-e / 中国输血杂志

Objective To understand the difference of serological characteristic between alloantibodies,'simple'Rhspecific autoantibodies and autoantibodies mimicking alloantibodies by studies of a patient who produces alloantibodies and autoantibodies that to distinguish Serologically them in order to more appropriate RBC component transfusion administration would be performed for patients.Methods Several serological methods were performed to the patient's serum samples for identification of antibodies by using two antibody screening cell reagents from different manufacturers.Using adsorption of the patient's Rh antibodies in the presence of LISS with the antibody was similar to that of the antigen negative cell from a donor who had a ccDEE Rh type and O type,and to detect antibodies in the absorbed serum and the eluting solution.Results The patient had a ccDEE Rh type with a positive direct antiglobulin test (DAT).Serum antibodies were identified as IgM anti-C,anti-e and IgG anti-e;the possibility of anti-Ce antibody is not excluded.After absorption,serum antibodies were identified as IgM anti-C,anti-e and IgG anti-e;anti-Ce antibody is not excluded.The antibody in patient's RBC elution was identified as IgG anti-e antibody.Conclusion Alloantibody and mimicking alloantibody can be distinguished by comprehensive analysis of patient's Rh phenotype,DAT result and antibody specificity in the serum and absorbed serum and elution of RBC.The low affinity antibody can be better absorbed by adding low ionic liquid (LISS).

A Case with Changes in Autoantibodies with Mimicking Specificity in a Patient with Hepatocellular Carcinoma / 대한수혈학회지

Changes in autoantibodies with mimicking specificity for Rh antigens are quite rare. Here, we report a 73-year-old male patient with hepatocellular carcinoma that showed changes in the autoantibodies with mimicking specificity. He was admitted to our hospital with mental alterations and hypoglycemia. The antibody identification test for RBC transfusion showed a pattern of agglutination, suggesting anti-E alloantibody and anti-c autoantibody. The patient was then diagnosed with hepatocellular carcinoma, and after 18 months, the antibody identification test showed a different pattern of agglutination, suggesting anti-E alloantibody and anti-C autoantibody. We recommend a careful evaluation to make sure an appropriate transfusion is performed when encountering fluctuating autoantibodies with mimicking specificity.

A Turkish Patient With Succinyl-CoA:3-Oxoacid CoA Transferase Deficiency Mimicking Diabetic Ketoacidosis

Abstract Succinyl-CoA:3-oxoacid CoA transferase (SCOT) deficiency is an autosomal recessive disorder of ketone body utilization that is clinically characterized with intermittent ketoacidosis crises. We report here the second Turkish case with SCOT deficiency. She experienced 3 ketoacidotic episodes: The first ketoacidotic crisis mimicked diabetic ketoacidosis because of the associated hyperglycemia. Among patients with SCOT deficiency, the blood glucose levels at the first crises were variable, and this case had the highest ever reported blood glucose level. She is a compound heterozygote with 2 novel mutations, c.517A>G (K173E) and c.1543A>G (M515V), in exons 5 and 17 of the OXCT1 gene, respectively. In patient's fibroblasts, SCOT activity was deficient and, by immunoblot analysis, SCOT protein was much reduced. The patient attained normal development and had no permanent ketosis. The accurate diagnosis of SCOT deficiency in this case had a vital impact on the management strategy and outcome.

Bronquiolite obliterante com pneumonia organizada simulando síndrome de Pancoast / Bronchiolitis obliterans organizing pneumonia mimicking Pancoast syndrome

É descrito o caso de um paciente de 52 anos, tabagista, que procurou atendimento médico queixando-se de dor em região interescápulo vertebral direita acompanhada de parestesia distal de metacarpos ipsilateral, febre, tosse produtiva e perda ponderal. Ao exame físico, havia presença de murmúrio vesicular diminuído em ápice pulmonar direito. A radiografia de tórax evidenciava opacidade neste mesmo local e na tomografia computadorizada, havia presença de massa encapsulada lobo superior direito, com mediastino superior desviado para esquerda e presença de linfadenomegalias. Com a hipótese de neoplasia pulmonar e síndrome de Pancoast, foi solicitado uma mediastinoscopia com biópsia cujo resultado foi inconclusivo. Logo, optou-se pela toracotomia para retirada da massa e realização de biópsia cujo resultado foi confirmatório para BOOP. Para o tratamento, optou-se por prednisona, cuja resposta foi efetiva.

Cryptococcal Brainstem Abscess Mimicking Brain Tumors in an Immunocompetent Patient

Usually fungal infections caused by opportunistic and pathogenic fungi had been an important cause of morbidity and mortality among immunocompromised patients. However clinical data and investigations for immunocompetent pathogenic fungal infections had been rare and neglected into clinical studies. Especially Cryptococcal brainstem abscess cases mimicking brain tumors were also much more rare. So we report this unusual case. This 47-year-old man presented with a history of progressively worsening headache and nausea for 1 month and several days of vomituritions before admission. Neurological and laboratory examinations performed demonstrated no abnormal findings. Previously he was healthy and did not have any significant medical illnesses. A CT and MRI scan revealed enhancing 1.8x1.7x2.0 cm mass lesion in the left pons having central necrosis and peripheral edema compressing the fourth ventricle. And also positron emission tomogram scan demonstrated a hot uptake of fluoro-deoxy-glucose on the brainstem lesion without any evidences of systemic metastasis. Gross total mass resection was achieved with lateral suboccipital approach with neuronavigation system. Postoperatively he recovered without any neurological deficits. Pathologic report confirmed Cryptococcus neoformans and he was successively treated with antifungal medications. This is a previously unreported rare case of brainstem Cryptococcal abscess mimicking brain tumors in immunocompetent host without having any apparent typical meningeal symptoms and signs with resultant good neurosurgical recovery.

Prevalence of Benign Diseases Mimicking Lung Cancer: Experience from a University Hospital of Southern Brazil / 결핵및호흡기질환

BACKGROUND: Lung cancer is the most lethal type of cancer in the world. Several benign lung diseases may mimic lung carcinoma in its clinical and radiological presentation, which makes the differential diagnosis for granulomatous diseases more relevant in endemic regions like Brazil. This study was designed to describe the prevalence and the diagnostic work-up of benign diseases that mimic primary lung cancer in patients hospitalized at a university hospital from south of Brazil. METHODS: This was a transversal study, which evaluated the medical records of 1,056 patients hospitalized for lung cancer treatment from September 2003 to September 2013 at University Hospital of Santa Maria. RESULTS: Eight hundred and four patients underwent invasive procedures for suspected primary lung carcinoma. Primary lung cancer was confirmed in 77.4% of the patients. Benign disease was confirmed in 8% of all patients. Tuberculosis (n=14) and paracoccidioidomycosis (n=9) were the most frequent infectious diseases. The diagnosis of benign diseases was obtained by flexible bronchoscopy in 55.6% of the cases and by thoracotomy in 33.4%. CONCLUSION: Infectious diseases are the most frequent benign diseases mimicking lung cancer at their initial presentation. Many of these cases could be diagnosed by minimally invasive procedures such as flexible bronchoscopy. Benign diseases should be included in the differential diagnosis during the investigation for primary lung cancer in order to avoid higher cost procedures and mortality.

Thoracic Spine Tumor Mimicking Cauda Equina Syndrome / 계명의대학술지

Cauda equina syndrome (CES) is one of the typical symptoms condition requires emergency operation. This syndrome is always accompanied by sciatica. Because schwannomas rarely cause sciatica, it is seldom considered as a pain source in the patient with radiculopathy. A 74-year-old male patient presented with lumbar radiculopathy symptoms with, mild stenosis on lumbar MRI scan. All conservative treatment including medication failed to subside the symptoms. Thoracic spine MRI revealed a large tumor in the thoracic region. The symptoms disappeared after excision of the tumor. The tumor was diagnosed as a schwannoma.

Basal Cell Carcinoma-Mimicking Lesions in Korean Clinical Settings

BACKGROUND: Basal cell carcinoma (BCC) is the most common form of skin cancer and possesses various clinical features including translucency, ulceration, pigmentation, telangiectasia, and rolled borders. Accordingly, many cutaneous lesions can mimic BCCs and differential diagnosis is difficult. OBJECTIVE: To clarify the differences in clinical characteristics between BCCs and BCC-mimicking lesions (BMLs), and to determine which clinical characteristics are helpful for an accurate clinical diagnosis of BCC. METHODS: We performed clinicopathologic analysis of cutaneous lesions that received a clinical diagnosis of BCC. All lesions included in this study showed more than one of the following characteristics of BCCs: translucency, ulceration, flecked pigmentation, black or blue hue, telangiectasia, and rolled borders. We compared six clinical characteristics between the BCC group and the BML group. RESULTS: Among 48 lesions in the BML group, there were 15 premalignant or malignant lesions and 33 benign lesions. Various dermatoses mimicking BCC that have not been reported in the dermatological literature were identified, including angiosarcoma, vulvar intraepithelial neoplasm, foreign body granuloma, intravascular papillary endothelial hyperplasia, sarcoidosis, and others. Compared to the BML group, the BCC group had a significantly higher frequency of translucency (76.3% vs. 52.1%, p<0.001), ulceration or erosion (44.2% vs. 27.1%, p=0.022), black or blue hue (40.0% vs. 22.9%, p=0.020), and rolled borders (49.5% vs. 14.6%, p<0.001). Cutaneous lesions with two or less clinical features of BCC were significantly more likely to be BMLs. CONCLUSION: The results of this study could be helpful for the differential diagnosis of BCCs and BCC-mimicking cutaneous lesions.

Idiopathic Hypertrophic Spinal Pachymeningitis with an Osteolytic Lesion

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic, progressive, inflammatory disorder characterized by marked fibrosis of the spinal dura mater with unknown etiology. According to the location of the lesion, it might induce neurologic deficits by compression of spinal cord and nerve root. A 58-year old female with a 3-year history of progressive weakness in both lower extremities was referred to our institute. Spinal computed tomography (CT) scan showed an osteolytic lesion involving base of the C6 spinous process with adjacent epidural mass. Magnetic resonance imaging (MRI) revealed an epidural mass involving dorsal aspect of cervical spinal canal from C5 to C7 level, with low signal intensity on T1 and T2 weighted images and non-enhancement on T1 weighted-enhanced images. We decided to undertake surgical exploration. At the operation field, there was yellow colored, thickened fibrous tissue over the dura mater. The lesion was removed totally, and decompression of spinal cord was achieved. Symptoms improved partially after the operation. Histopathologically, fibrotic pachymeninges with scanty inflammatory cells was revealed, which was compatible with diagnosis of idiopathic hypertrophic pachymeningitis. Six months after operation, motor power grade of both lower extremities was normal on physical examination. However, the patient still complained of mild weakness in the right lower extremity. Although the nature of IHSP is generally indolent, decompressive surgery should be considered for the patient with definite or progressive neurologic symptoms in order to prevent further deterioration. In addition, IHSP can present as an osteolytic lesion. Differential diagnosis with neoplastic disease, including giant cell tumor, is important.

Autoantibodies with Mimicking Specificity Detected by the Dilution Technique in Patients with Warm Autoantibodies

BACKGROUND: The aim of this study was to investigate the frequency of autoantibodies with mimicking specificity by using the dilution technique, to assess the usefulness of the combination of the dilution technique and red blood cell (RBC) phenotyping, and to establish a pre-transfusion testing algorithm in patients with warm autoantibodies. METHODS: Serum samples from 71 patients with warm autoantibodies were tested using the dilution technique. Among them, 25 samples were adsorbed with allogeneic ZZAP (a combination of dithiothreitol and enzyme) or polyethylene glycol (PEG) and their RBC phenotypes were determined. Thirty-nine patients were transfused with our pre-transfusion testing algorithm using a combination of dilution technique and RBC phenotyping. RESULTS: Autoantibodies with mimicking specificity were detected by the dilution technique in 26.8% (19/71) of the patients and most of them were directed against Rh system antigens. The agreement of the results obtained with the dilution technique in combination with RBC phenotyping and those from ZZAP or PEG adsorption was 100% (18/18) in patients who have autoantibodies with mimicking specificity and/or alloantibodies. No clinical symptoms indicating severe acute or delayed hemolytic transfusion reactions were reported in the 39 patients transfused with our pre-transfusion testing algorithm. CONCLUSIONS: Autoantibodies with mimicking specificity detected by the dilution technique in patients with warm autoantibodies are relatively frequent, can be discriminated from alloantibodies by employing a combination of dilution technique and RBC phenotyping, and might not appear to cause severe acute or delayed hemolytic transfusion reactions.