The natural anticoagulant-activated protein C may inhibit inflammation and fibrosis in the lung. Platelet-derived growth factor is involved in the pathogenesis of lung fibrosis. This study assessed the effect of activated protein C on platelet-derived growth factor expression in human cell lines and in an in vivo model of lung fibrosis. Activated protein C significantly inhibited the secretion and expression of platelet-derived growth factor in human lung cell lines, primary bronchial epithelial cells, and macrophages. In vitro studies also showed that the endothelial activated protein C receptor is expressed by lung epithelial cells and macrophages, and that this receptor and the proteolytic activity of activated protein are implicated in the inhibition of platelet-derived growth factor expression. In the in vivo model of lung fibrosis, intratracheal administration of activated protein C decreased the expression of platelet-derived growth factor and suppressed the development of lung fibrosis. Concomitant intratracheal administration of activated protein C and anti-endothelial activated protein C receptor or anti-platelet-derived growth factor suppressed the inhibitory activity of activated protein C in vivo. In brief, this study describes a novel biological function of activated protein C that may further explain its inhibitory activity on lung inflammation and fibrosis.

There is a high incidence of RE after successful H. pylori eradication therapy. This incidence of RE was closely associated with the presence and degree of hiatal hernia and with the decrease in gastric juice pH. These findings suggest that the presence of hiatal hernia together with increase in gastric acidity are important determinant factors for the development of RE after successful H. pylori eradication therapy.

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This study showed for the first time that Lf is present in gastric juice and that it correlates with H. pylori infection. Lf may constitute a good marker for H. pylori-associated gastritis. Although correlation does not prove causation, this study suggests that Lf might play an important role in the physiopathology of H. pylori-associated gastritis.

resulting from probable lymphatic duct injuries during lymph node dissection for a gastric malignancy. Gastrectomy with lymph node dissection is performed acceptably in most Japanese institutions; however, lymphorrhea is frequently encountered after gastric surgery, although the postoperative lymphatic leakage generally stops spontaneously without treatment. There is, though, little information about a standard treatment for postoperative lymphorrhea, which is highly refractory to any conventional medical treatments such as cessation of oral intake, total parenteral nutrition (TPN) management, diuretic therapy, intravenous reinfusion of ascites, or therapeutic paracentesis.Here, we present a case of intractable lymphorrhea in a patient who was successfully treated with surgical lymph vessel ligation, and subsequent OK-432 (Picibanil; Chugai Pharmaceutical, Tokyo, Japan) sclerotherapy. Additionally, we review the present case and the 17 previous reports noted above, and discuss management options. Case reportA 66-year-old man was referred to our department for medical treatment for refractory ascites. One year before admission, he had undergone, in our department, a total gastrectomy with lymphadenectomy for early gastric cancer. Because preoperative study showed that the tumor had probably invaded to the submucosal layer, we performed extended lymph node dissection, including the regional lymph nodes and additional lymph nodes, along the common hepatic artery. His postoperative course was uneventful. The final, pathological staging was T1 (SM), N0, H0, P0, M0, stage IA according to the Japanese classification of gastric carcinoma, second edition [23]. He had chronic B-type viral hepatitis, and was non-cirrhotic, but with normal liver function tests. There was no evidence of recurrence on the basis of Abstract Postoperative hepatic lymphorrhea is a very rare complication after abdominal surgery. Hepatic lymphorrhea, not containing chyle, involves an internal lymph fistula between the lymphatic channels toward the cisterna chyli and the peritoneal cavity. Over the past 20 years, 17 cases have been reported in Japan. Here, we report a further case, of a patient with successfully treated intractable hepatic lymphorrhea following gastrectomy for early gastric cancer. We review 18 cases, including the present case, with respect to the management of postoperative lymphorrhea refractory to conventional medical treatment.