Summary. Background Small cell lung cancer (SCLC) is a chemotherapy-responsive tumor type but most patients ultimately experience disease progression. SCLC is associated with alterations in the coagulation system. The present randomized clinical trial (RCT) was designed to determine whether addition of low-molecular-weight heparin (LMWH) to combination chemotherapy (CT) would improve SCLC outcome compared with CT alone. Methods Combination CT consisted of cyclophosphamide, epirubicine and vincristine (CEV) given at 3-weekly intervals for six cycles. Eighty-four patients were randomized to receive either CT alone (n ¼ 42) or CT plus LMWH (n ¼ 42). LMWH consisted of dalteparin given at a dose of 5000 U once daily during the 18 weeks of CT. Results Overall tumor response rates were 42.5% with CT alone and 69.2% with CT plus LMWH (P ¼ 0.07). Median progression-free survival was 6.0 months with CT alone and 10.0 months with CT plus LMWH (P ¼ 0.01). Median overall survival was 8.0 months with CT alone and 13.0 months with CT plus LMWH (P ¼ 0.01). Similar improvement in survival with LMWH treatment occurred in patients with both limited and extensive disease stages. The risk of death in the CT + LMWH group relative to that in the CT group was 0.56 (95% confidence interval 0.30, 0.86) (P ¼ 0.012 by log rank test). Toxicity from the experimental treatment was minimal and there were no treatment-related deaths. Conclusions These results support the concept that anticoagulants, and particularly LMWH, may improve clinical outcomes in SCLC. Further clinical trials of this relatively non-toxic treatment approach are indicated.

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ABSTRACT:Technical information and data on the physical and mechanical properties of agricultural and animal products are necessary to design various equipments for agriculture and industry. In this study some physical properties such as mass, length, diameter, geometric mean diameter, surface area, sphericity, volume, coefficient of friction and packaging coefficient were determined for Japanese quail eggs. Furthermore, the mechanical behaviour of Japanese quail eggs was determined in terms of average rupture force, deformation and toughness (energy absorbed by the Japanese quail eggs per unit volume). Egg samples were compressed along their X and Z-axes.The average values of their mass, length, width, shell thickness, geometric mean diameter, surface area, sphericity, volume and packaging coefficient were measured to be 12.69 g, 34.87 mm, 26.20 mm, 0.27 mm, 28.82 mm, 2 608.5 mm 2 , 1.10, 359.17 mm 3 , 0.469, respectively. The values of the coefficient of friction for quail eggs on the surfaces of plywood, glass, galvanized steel and fibreglass were 0.301, 0.282, 0.274 and 0.266, respectively. The highest rupture force, deformation and toughness were obtained when Japanese quail eggs were loaded along their X-axis. Compression along the Z-axis required the least compressive force to break the eggs as compared to the other compression axes. Rupture force, deformation, absorbed energy and toughness for the X-front axis were determined to be 10.51 N, 1.5 mm, 7.88 Nmm and 0.219 Mj/mm 2 , respectively.

Objective:Catestatin has several cardiovascular actions, in addition to diminished sympatho-adrenal flow. Decreased plasma catestatin levels may reflect a predisposition for the development of hypertension and metabolic disorders. We planned to investigate the possible roles of catestatin in untreated hypertensive patients. As a secondary objective, we compared catestatin concentrations of healthy subjects with those of hypertensive patients in order to understand whether catestatin is increased reactively or diminished at onset.Methods:Our study was cross-sectional and observational. The patient group, comprising 109 consecutive untreated hypertensive patients without additional systemic or coronary heart disease, underwent evaluations of plasma catestatin, waist circumference, lipid parameters, left ventricular mass, carotid intima-media thickness, and flow-mediated dilation of the brachial artery. Additionally, we measured catestatin concentrations of 38 apparently healthy subjects without any disease using a commercial enzyme-linked immunosorbent assay kit.Results:We documented increased catestatin concentrations in previously untreated hypertensive patients compared to healthy controls (2.27±0.83 vs. 1.92±0.49 ng/mL, p=0.004). However, this association became insignificant after adjustments for age, gender, height, and weight. Within the patient group, catestatin levels were significantly higher in females. Among all study parameters, age, high-density lipoprotein cholesterol (HDL-C) correlated positively to plasma catestatin, whereas triglycerides, hemoglobin, and left ventricular mass correlated negatively to plasma catestatin. We could not detect an association between vascular parameters and catestatin. Catestatin levels were significantly elevated with increasing HDL-C (1.91±0.37, 2.26±0.79, and 3.1±1.23 ng/mL in patients with HDL-C <40, 40-60, and >60 mg/dL, respectively). Multiple linear regression analysis revealed age (beta: 0.201, p=0.041) and HDL-C (beta: 0.390, p<0.001) as independent correlates of plasma catestatin concentration. Additionally, male gender (beta:-0.330, p=0.001) and plasma catestatin (beta: 0.299, p=0.002) were significantly associated with HDL-C concentrations.Conclusion:We documented that plasma catestatin is an independent predictor of high-density lipoprotein cholesterol. In addition to antihypertensive effects, catestatin appears to be related to improved lipid and metabolic profiles. Coexistence of low catestatin levels with low HDL-C may provide a probable mechanism for the predictive value of low HDL-C for increased hypertension and cardiovascular events.

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