Overexpression of BRCA1 or BRCA2 in prostatectomy specimens is predictive of biochemical recurrence after radical prostatectomy.

AIMS: To investigate the protein expressions of breast cancer 1 (BRCA1) and 2 (BRCA2) in prostatectomy specimens of localized prostate cancer (PC) patients, along with their associations with cancer characteristics and prognosis. METHODS AND RESULTS: Immunohistochemistry for BRCA1 and BRCA2 was performed on tissue microarrays of 510 PC cases treated from 2002 to 2012. The cytoplasmic immunoreactivity was scored for intensity, and clinicopathological parameters, including biochemical recurrence (BCR), were evaluated. During a median follow-up of 44 months, 128 patients developed BCR, with positive staining rates of 93.3% (n = 476) and 41.6% (n = 212) for BRCA1 and BRCA2, respectively, in the malignant tissues. The BRCA2 expression differed significantly between BCR-positive and BCR-free cases [hazard ratio (HR): 1.75, P = 0.002]. BRCA1 and BRCA2 correlated significantly with age [odds ratio (OR): 0.131] and pN stage (OR: 6.00), pN stage (OR: 1.717) and BCR (OR: 1.972), respectively (P < 0.05). Multivariate analysis showed that BRCA1 (HR: 0.435), BRCA2 (HR: 2.45), pT3 stage (HR: 2.253), resection margin positivity (HR: 1.58), prostate size (HR: 0.975) and Gleason score (HR: 2.214-2.253) were independent predictors of BCR (P < 0.05). Moreover, BRCA2 correlated significantly with BCR-free survival (P = 0.0017). CONCLUSIONS: BRCA1 or BRCA2 overexpression is a significant predictive factor for BCR in PC patients.

Accuracy of Ultrasound-Guided and Non-guided Botulinum Toxin Injection Into Neck Muscles Involved in Cervical Dystonia: A Cadaveric Study.

OBJECTIVE: To compare the accuracy of ultrasound-guided and non-guided botulinum toxin injections into the neck muscles involved in cervical dystonia. METHODS: Two physicians examined six muscles (sternocleidomastoid, upper trapezius, levator scapulae, splenius capitis, scalenus anterior, and scalenus medius) from six fresh cadavers. Each physician injected ultrasound-guided and non-guided injections to each side of the cadaver's neck muscles, respectively. Each physician then dissected the other physician's injected muscle to identify the injection results. For each injection technique, different colored dyes were used. Dissection was performed to identify the results of the injections. The muscles were divided into two groups based on the difficulty of access: sternocleidomastoid and upper trapezius muscles (group A) and the levator scapulae, splenius capitis, scalenus anterior, and scalenus medius muscles (group B). RESULTS: The ultrasound-guided and non-guided injection accuracies of the group B muscles were 95.8% and 54.2%, respectively (p<0.001), while the ultrasound-guided and non-guided injection accuracies of the group A muscles were 100% and 79.2%, respectively (p<0.05). CONCLUSION: Ultrasound-guided botulinum toxin injections into inaccessible neck muscles provide a higher degree of accuracy than non-guided injections. It may also be desirable to consider performing ultrasound-guided injections into accessible neck muscles.

Spinal Accessory Nerve Injury Induced by Manipulation Therapy: A Case Report.

Spinal accessory nerve (SAN) injury mostly occurs during surgical procedures. SAN injury caused by manipulation therapy has been rarely reported. We present a rare case of SAN injury associated with manipulation therapy showing scapular winging and droopy shoulder. A 42-year-old woman visited our outpatient clinic complaining of pain and limited active range of motion (ROM) in right shoulder and scapular winging after manipulation therapy. Needle electromyography and nerve conduction study suggested SAN injury. Physical therapy (PT) three times a week for 2 weeks were prescribed. After a total of 6 sessions of PT and modality, the patient reported that the pain was gradually relieved during shoulder flexion and abduction with improved active ROM of shoulder. Over the course of 2 months follow-up, the patient reported almost recovered shoulder ROM and strength as before. She did not complain of shoulder pain any more.

Anticoagulant from Taraxacum platycarpum.

An anticoagulant was purified from a Chinese herb, Taraxacum platycarpum. Its activity was heat-labile, and was decreased by incubation with subtilisin Carlburg or proteinase K, indicating that the active component was a protein. The protein had a molecular mass of 31 kDa by gel filtration and 33 kDa by sodium dodecyl sulfate polyacrylamide gel electrophoresis, so it probably was a monomer. When present at the concentration of 70, 255, and 873 nM, respectively, the protein doubled the thrombin time, prothrombin time, and activated partial thromboplastin time. It inhibited thrombin and kallikrein, but did not hydrolyze fibrinogen. The protein bound the anion-binding exosite of thrombin, competing with the fibrinogen binding site. In addition, the protein caused the murine macrophage cell line Raw 264.7 to produce cyclooxygenase-2, nitric oxide synthase, nitric oxide, and tumor necrosis factor-alpha.