Background. Histidine-rich glycoprotein (HRG) displays anticoagulant and antifibrinolytic properties in animal models, but its effects in humans are unclear. We investigated serum HRG levels and their associations with the disease stage and prothrombotic alterations in lung cancer (LC) patients. Methods. In 148 patients with advanced LC prior to anticancer therapy (87 non-small-cell LC and 61 small-cell LC) versus 100 well-matched controls, we measured HRG levels in association with clot permeability (Ks), clot turbidimetry (lag phase and maximum absorbance), and clot lysis time (CLT). Results. Compared to controls, LC patients had 45.9% lower HRG levels with no associations with demographics and comorbidities. Decreased HRG, defined as the 90th percentile of control values (<52.7 μg/ml), was 16 times more common in subjects with than without LC (OR=16.4, 95% CI 9.2-23.5, p<0.01). HRG<38 μg/ml discriminated stage IIIAB/limited disease from IV/extensive disease (ED) LC. In LC patients, HRG correlated inversely with CLT (r=−0.41, p<0.001), but not with other fibrin variables. Among stage IV/ED LC, HRG correlated significantly with Ks and lag phase (r=0.28 and r=0.33, respectively, both p<0.001). LC patients with low Ks (10th percentile of control values) combined with prolonged CLT (90th percentile of control values) had reduced HRG levels compared to the remainder (p=0.003). No such observations were noted in controls. Conclusions. Our study is the first to show that decreased HRG levels occur in advanced LC and are associated with the disease stage and hypofibrinolysis.

The paper describes an original method of endoluminal electrical stimulation of the stomach developed by authors. The aim of the study was to compare two types of electrical stimulation: low frequency (LF) and high frequency (HF) in human patients. Twenty-three patients with postoperative gastroparesis (after abdominal surgery) were involved in the study and randomized into two groups. Group A consisted of 13 subjects treated by LF stimulation (mean age 52 ± 11; five males, eight females) and group B of 10 patients scheduled for HF stimulation (mean age 61 ± 8; six males, four females). A computer preprogrammable stimulator was used and the following parameters were evaluated: gastric retention every 12 h and symptoms score on the days 0, 1, 3, and 5. Gastric retention decreased in group A on consecutive days of pacing from 1,593 to 623, 407, 315, 246, to 192 ml, and in group B from 1,980 to 570, 218, 80, 15, to 0 ml (p < 0.05). Symptoms score decreased on the consecutive days of pacing from 8.3 to 3.8, 1.3, to 0.9 in the LF group and from 8.2 to 3.1, 1.0, to 0 in the HF group. We conclude that HF is more effective than LF in the treatment of postoperative gastroparetic human patients. No adverse effects of HF and LF were observed in this study.

Background Dense fibrin networks resistant to lysis have been reported in patients at high risk of thromboembolism. Little is known about fibrin clot properties in cancer. We investigated fibrin clot properties and their determinants in patients with inoperable lung cancer. Methods We enrolled 150 patients with advanced lung cancer prior to therapy and 90 control subjects matched by age, sex, cardiovascular disease, and diabetes. Plasma clot permeability (K s), turbidimetric analysis of clot formation, clot lysis time (CLT), microparticle-associated tissue factor (MP-TF) activity, thrombin generation, and serum cotinine levels were determined. Results Lung cancer patients, compared with controls, formed at a faster rate (− 8.1% lag phase) denser plasma fibrin networks (− 27.2% K s) that displayed impaired lysis (+ 26.5% CLT), along with 19.5% higher MP-TF activity and 100% higher peak thrombin generated, also after adjustment for potential confounders. Cotinine levels were associated with fibrin maximum absorbance (r = 0.20, p = 0.016) and K s (r = − 0.50, p < 0.0001) in cancer patients. On multivariate regression analysis, an increase in cotinine levels was a predictor of low K s (the lower quartile, < 5.8 × 10 −9 cm 2 ; odds ratio = 1.21 per 10 ng/ml, 95% confidence interval 1.02-1.46), but not CLT. Conclusion Advanced lung cancer is associated with the prothrombotic plasma clot phenotype largely driven by smoking.