Upper Tract Urothelial Carcinoma Complicated by Skeletal Muscle Metastases.

Urothelial carcinoma typically metastasizes via a lymphatic route to sites such as lymph nodes, bone, and liver. As in other malignancies, metastasis to skeletal muscle is rare. We present a case of a 66-year-old male with severe muscular pain after diagnosis of upper tract urothelial carcinoma, who was found to have extensive metastasis to skeletal muscles including gluteal, sternocleidomastoid, deltoid, vastus lateralis, and gastrocnemius muscles.

Not All Leiomyosarcomas Are the Same: How to Best Classify LMS.

Leiomyosarcoma arises from smooth muscle and represents one of the most common soft tissue sarcomas. Despite aggressive multimodality care, over half of the patients will ultimately develop metastatic and incurable disease with a median survival of 12-18 months. At present, there is no standard system to classify leiomyosarcoma, which itself is a heterogeneous disease.

An unusual case of aggressive malignant spread of epithelioid hemangioendothelioma.

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm which typically originates from liver, lung, or bone. Due to the low incidence of disease, the most effective treatment is not easily studied and much of the information known about EHE has been learned through case reports and case series. In this case, we will present an uncommon form of primary soft tissue EHE with local recurrence, bone metastasis, and lymphangitic spread to the lungs leading to respiratory failure.

Image-Based Analysis of Protein Stability.

Short half-life proteins regulate many essential processes, including cell cycle, transcription, and apoptosis. However, few well-characterized protein-turnover pathways have been identified because traditional methods to measure protein half-life are time and labor intensive. To overcome this barrier, we developed a protein stability probe and high-content screening pipeline for novel regulators of short half-life proteins using automated image analysis.

Myc and its interactors take shape.

The Myc oncoprotein is a key contributor to the development of many human cancers. As such, understanding its molecular activities and biological functions has been a field of active research since its discovery more than three decades ago. Genome-wide studies have revealed Myc to be a global regulator of gene expression.

Metformin compared with insulin in the treatment of pregnant women with overt diabetes: a randomized controlled trial.

Objective: To compare the safety and tolerability of metformin to insulin for glycemic control among women with preexisting type 2 and early A2 gestational diabetes.

Study Design: Women with preexisting type 2 diabetes and those diagnosed with gestational diabetes who required medical management prior to 20 weeks were randomly assigned to metformin or insulin. Glycemic control, defined as >50% capillary blood glucose within target range, was compared between groups.

Efficacy of an accelerated hepatitis B vaccination program during pregnancy.

Objective: To estimate the feasibility and immunogenicity of an accelerated hepatitis B vaccination schedule of 0, 1, and 4 months in high-risk pregnant women.

Methods: We conducted a prospective clinical trial of high-risk pregnant women who were hepatitis B surface antigen-negative at presentation for prenatal care. A detailed questionnaire was administered and eligible women received a hepatitis B vaccine intramuscularly on a 0-, 1-, and 4-month schedule.

Maternal periodontal disease is associated with oxidative stress during pregnancy.

We sought to determine if maternal periodontal disease is associated with oxidative stress as measured by serum 8-isoprostane. A secondary analysis was conducted using prospective data from the Oral Conditions and Pregnancy Study. Healthy women enrolled at < 26 weeks' gestational age underwent oral examination and serum sampling.

Severe separation of the pubic symphysis and prompt orthopedic surgical intervention.

Background: The incidence of pubic symphysis separation during delivery is 1 in 300 to 1 in 30,000 pregnancies, and it can cause a variety of problems such as pain, bladder dysfunction, and difficulty ambulating. There is no consensus on how to treat pregnancy-related pubic symphyseal separation.

Case: A patient, gravida 1 para 1, who underwent vacuum-assisted vaginal delivery was found to have a severe vaginal sidewall laceration and a 6.