Plasma Chemokine C-C Motif Ligand 2 as a Potential Biomarker for Prostate Cancer.

PURPOSE: Serum levels of the polypeptide chemokine C-C motif ligand 2 (CCL2) have previously shown potential as a prostate cancer diagnostic and prognostic biomarker. Plasma CCL2 levels may be superior to serum levels as a biomarker because of their potentially lower signal-to-noise ratio. MATERIALS AND METHODS: Before initiating a large comparative study of plasma and serum CCL2 levels, we performed a prospective, diagnostic pilot study Of 133 individuals from a clinically relevant population. CCL2 plasma levels were measured using a validated assay kit. Plasma was obtained independently of digital rectal examination. RESULTS: In this pilot study, we found no relationship between CCL2 plasma values and risk of proven prostate cancer, whereas previous studies found a strong diagnostic relationship between CCL2 serum values and prostate cancer. CONCLUSION: Our contribution to the existing literature strengthens the idea that early in the pathological process, CCL2 mainly circulates in large, membrane-enclosed compartments, whereas plasma CCL2 levels increase markedly during disease progression. We conclude that whereas plasma CCL2 levels are not useful as a diagnostic measure, a ratio of CCL2 plasma to serum levels may prove useful as a marker of disease progression, which warrants further study.

Comparison of venous thromboembolic complications following urological surgery between patients with or without cancer.

OBJECTIVE: Guidelines recommend 4 weeks of thromboembolic prophylaxis in patients who undergo major surgery for solid malignancies. However, there are limited head-to-head comparisons of risk of venous thromboembolic complications in patients with and without cancer undergoing similar surgical procedures. The purpose of this study was to compare risk of venous thromboembolic complications following major renal surgery and cystectomy between patients with and without cancer at the time of surgery. MATERIAL AND METHODS: In the nationwide Danish National Patient Registry, which captures all hospital contacts, including surgical procedures, we identified 8,645 patients who underwent major renal surgery (4,273 without cancer and 4,372 with cancer) and 2,164 patients who underwent cystectomy (359 without cancer and 1,805 with cancer) in 2000-2009. The rate of venous thromboembolic events within 6 months from surgery was compared for patients with and without cancer after stratification on organ using Chi-squared test. RESULTS: There was no difference in the rate of venous thromboembolic complications within the first 6 months after major renal surgery (0.4% and 0.3% [p=0.91]) or cystectomy (1.3% and 0.8% [p=0.44]) for patients with and without cancer. The cost for 28 days of Tinzaparin 4.500 IE administered by the patient was €112, whereas the cost if administered by a community nurse was €1.988. CONCLUSIONS: Our study questions the different recommendations in thromboembolic prophylaxis between patients with and without cancer after major renal surgery and cystectomy.

Comparative study of lung sealants in a porcine ex vivo model.

BACKGROUND: Lung sealants are often used to prevent alveolar air leaks after lung resection surgery. Some sealants have shown to be effective in clinical studies, but extensive comparative evaluation has not yet been conducted. We aimed to evaluate different sealant burst pressures in an ex vivo model mimicking air leakage after lung resection. METHODS: Fifty-four porcine lungs comprised the study material. Six different sealants were evaluated: Bioglue (V-Tech, Roskilde, Denmark), TachoSil (Nycomed, Roskilde, Denmark), Tisseel (Baxter, Allerød, Denmark), Evicel (OMRIX biopharmaceuticals S.A, Rhode-St-Genèse, Belgium), TissuePatchDural (Vingmed, Roskilde, Denmark), and Pleuraseal (Covidien, Copenhagen, Denmark). After creating a standardized pleural defect, each lung was randomized into 1 of the 6 treatment groups (n= 9). Each lung was ventilated with incremental airway pressure. Air leakage was assessed after each increment. If leakage occurred, the burst pressure was recorded. RESULTS: The Evicel fibrin sealant and Tisseel fibrin sealant exhibited significantly lower burst pressures compared with the Bioglue, TachoSil, and Pleuraseal (p < 0.05). Bioglue had the highest median burst pressure (55 cm H(2)O) followed by TachoSil (35 cm H(2)O), PleuraSeal (35 cm H(2)O), TissuePatchDural (25 cm H(2)O), Evicel (15 cm H(2)O), and Tisseel (15 cm H(2)O). CONCLUSIONS: This model has shown to be feasible in determining and comparing the burst pressures of different lung sealants. Further studies are needed to determine responses in living tissue and burst pressure over time in vivo.

Degenerative processes in bioprosthetic mitral valves in juvenile pigs.

BACKGROUND: Glutaraldehyde-treated bioprosthetic heart valves are commonly used for replacement of diseased heart valves. However, calcification and wear limit their durability, and the development of new and improved bioprosthetic valve designs is needed and must be evaluated in a reliable animal model. We studied glutaraldehyde-treated valves 6 months after implantation to evaluate bioprosthetic valve complications in the mitral position in juvenile pigs. MATERIALS: The study material comprised eight, 5-month old, 60-kg pigs. All pigs received a size 27, glutaraldehyde-treated, stented, Carpentier-Edwards S.A.V. mitral valve prosthesis. After six months, echocardiography was performed, and the valves explanted for gross examination, high resolution X-ray, and histological evaluation. RESULTS: Five pigs survived the follow-up period. Preexplant echocardiography revealed a median peak and mean velocity of 1.61 m/s (range: 1.17-2.00) and 1.20 (SD = ±0.25), respectively, and a median peak and mean pressure difference of 10.42 mmHg (range: 5.83-16.55) and 6.51 mmHg (SD = ±2.57), respectively. Gross examination showed minor thrombotic depositions at two commissures in two valves and at all three commissures in three valves. High resolution X-ray imaging revealed different degrees of calcification in all explanted valves, primarily in the commissural and belly areas. In all valves, histological evaluation demonstrated various degrees of fibrous sheath formation, limited immunological infiltration, and no overgrowth of host endothelium. CONCLUSIONS: Bioprosthetic glutaraldehyde-treated mitral valves can be implanted into the mitral position in pigs and function after 6 months. Echocardiographic data, calcification, and histological examinations were comparable to results obtained in sheep models and human demonstrating the suitability of the porcine model.