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Background: The clinical significance of CD8‐positive (CD8+) lymphocytes on tumor cell clusters of ascites cell blocks in patients with ovarian high‐grade serous carcinoma (HGSC) was investigated. Methods: Among HGSC patients who underwent surgery from January 2014 to December 2019, 38 patients with ascites cell block were selected. Using these cell blocks and primary ovarian tumor tissue, the presence of CD8+ lymphocytes and the expression of PD‐L1 were examined immunohistochemically. Tumor cell clusters were defined as cell clumps consisting of more than 10 malignant cells in cell block. Cases with at least one CD8+ lymphocyte in tumor cell cluster were defined as positive CD8+ lymphocytes (Group A); others were defined as negative CD8+ lymphocytes (Group B). The tumor tissue CD8+ lymphocytes were counted mechanically. Clinicopathological features were retrospectively compared between the two groups. Results: In total, 38 cases were identified: 25 (65.8%) in Group A and 13 (34.2%) in Group B. More cases in Group A were positive for CD4 (p < 0.01), PD‐L1 (p = 0.02), FoxP3 (p = 0.02) and had a higher number of CD8+ lymphocytes in the tissue (p = 0.03). Patients in Group A had better progression‐free survival (p < 0.01) and overall survival (p = 0.04). In multivariate analysis, Group A was an independent prognostic factor for both progression‐free survival (hazard ratio, 0.24; p < 0.01) and overall survival (hazard ratio, 0.21; p = 0.03). Conclusion: The presence of CD8+ lymphocytes in tumor cell clusters of ascites was associated with the status of immune reaction in the tissue and prognosis in patients with HGSC and might be useful information of the immune‐associated therapy. [ABSTRACT FROM AUTHOR]

Introduction: Placenta previa with placenta accreta spectrum (PAS) is a life-threatening disease that results in massive hemorrhage. The clinical and histologic criteria of PAS were adopted according to the International Federation of Gynaecology and Obstetrics (FIGO) classification. We aimed to investigate whether FIGO criteria and topography were associated with maternal complications in patients with placenta previa.Material and Methods: Patients with placenta previa who underwent cesarean section at our institution between January 2003 and December 2019 were identified. First, they were divided based on FIGO classification, as follows: Group A, with clinical criteria; Group B, with histologic criteria; and Group C: without clinical or histologic criteria. Next, cases with PAS were classified according to the topographic invasion area, as follows: type 1, upper posterior bladder; type 2, lower posterior bladder; type 3, parametrium; type 4, posterior lower uterine segment. Predictive factors for massive hemorrhage were retrospectively analyzed.Results: Among the 350 patients, 24 (6.9%) were classified as Group A, 16 (4.6%) as Group B and 310 (88.5%) as Group C. Regarding maternal history and hemostatic procedures, there were no significant factors other than hysterectomy (p < .01) in Groups A and B. The volume of blood loss in both Groups A and B was greater than in Group C (p < .01). The rates of uterine artery embolization and blood transfusion were higher in Groups A and B than in Group C (p < .01). In addition, there were no significant factors other than hysterectomy between Groups A and B. In the multivariate analysis for massive hemorrhage, Group A (odds ratio: 2.73, p = .04) and Group B (odds ratio: 12.69, p < .01) were identified as independent predictive factors. In addition, massive hemorrhage was closely related to the lower posterior bladder and parametrial invasion in both Groups A and B.Conclusions: Both clinical and histologic criteria for PAS in the FIGO classification were associated with massive hemorrhage. Diagnosing clinical PAS using the FIGO classification, additional hemostatic procedures might be necessary according to the topographic invasion area. [ABSTRACT FROM AUTHOR]

Aim: To investigate the differences in epithelial‐mesenchymal transition (EMT)‐ and matrix metalloproteinases (MMP)‐related factors among placenta previa with and without placenta accreta spectrum (PAS) (n = 69), and normal placenta (n = 51). Methods: The women diagnosed with placenta previa with or without PAS, and normal placentas, who delivered at our institution between 2006 and 2016, were enrolled. The difference of EMT‐related factors' expression by immunochemical analysis in chorionic villi and decidual cells between the normal placenta and placenta previa with or without PAS were evaluated. Results: In chorionic villi of placenta previa with and without PAS, E‐cadherin expression decreased, while that of ZEB1, SNAIL2 and MMP‐9 increased than that in normal placenta. In decidual cells of placenta previa with and without PAS, expression of vimentin, ZEB1 and MMP‐9 increased than that in normal placenta. In placenta previa with and without PAS, there was strong co‐expression of ZEB1 and vimentin in chorionic villi, of ZEB1 and MMP‐2 or MMP‐9 in decidual cells, and of SNAIL2 and vimentin or MMP‐9 in both chorionic villi and decidual cell. Vimentin expression in both chorionic villi and decidual cells was higher in placenta previa with PAS (n = 18) than in placenta previa without PAS (n = 51). MMP‐2 expression in decidual cells was higher in placenta previa with PAS than in placenta previa without PAS. Conclusion: This study revealed that EMT‐ and MMP‐associated factors may be related to placenta previa with and without PAS. Furthermore, placenta previa without PAS may acquire invasive nature. [ABSTRACT FROM AUTHOR]

Introduction: Massive hemorrhage due to placenta previa with placenta accreta spectrum is associated with high maternal mortality and morbidity. Therefore, accurate prediction of placenta previa with placenta accreta spectrum is essential; magnetic resonance imaging (MRI) is a useful tool for this purpose. This study investigated novel predictors of anterior and posterior placenta previa with placenta accreta spectrum using MRI. Material and methods: This was a retrospective study at a tertiary obstetrics hospital in Japan. The singleton patients with placenta previa who were scanned with MRI prenatally and had a cesarean section at our institution between 2007 and 2018 were included. The prediction of anterior and posterior placenta previa with placenta accreta spectrum was evaluated using four MRI findings: heterogeneous signals in the placenta, dark T2‐weighted intraplacental bands, myometrial thinning or interruption, and focal uterine bulging. The prediction of posterior placenta previa with placenta accreta spectrum was performed using the quantification of cervical varicosities, which were defined as the ratio of the distance between the minimum distance from the most dorsal cervical varicosities (a) to the deciduous and amniotic placenta (b) on a sagittal image. Results: Among 202 patients, 14 (6.9%) patients were pathologically diagnosed as having placenta accreta spectrum. Further, 38 (18.8%) patients had anterior placenta previa and 164 (81.2%) patients had posterior placenta previa. When anterior placenta previa with placenta accreta spectrum was predicted using at least one of the four MRI findings, the sensitivity and specificity of the anterior placenta previa with placenta accreta spectrum were 87.5% and 86.7%, respectively. In contrast, the sensitivity and specificity of posterior placenta previa with placenta accreta spectrum were 42.9% and 96.2%, respectively. But when the A/B ratio was set at 0.20, the sensitivity and specificity of the prediction for posterior placenta previa with placenta accreta spectrum using cervical varicosities were 100.0% and 89.2%, respectively. Conclusions: The findings of MRI to predict the anterior placenta previa with placenta accreta spectrum were different from posterior placenta previa. The cervical varicosities may be useful in predicting posterior placenta previa with placenta accreta spectrum. [ABSTRACT FROM AUTHOR]

This study reports on Japanese university-level EFL teacher (N = 50) and student (N = 660) reactions to the notion of making English an official language, as proposed by an advisory board to Prime Minister Obuchi in 2000. The study also reports on beliefs about English language learning and teaching in general in terms of goals, proficiencies of Japanese people, and appropriate instructional styles for Japanese. Students appeared to believe that it would be beneficial to be proficient in English, although a number of them did not welcome English-only EFL classes. Students tended to link beliefs about English proficiency to legislating English as an official language, while their reactions to the officialization of the language varied widely. Teachers’ beliefs, on the other hand, appeared to be drawn from their own experiences in current English-using contexts in Japan. The majority of teachers indicated that English should not be given official language status, and that people would not use English in their daily life even if it were to become official. [ABSTRACT FROM AUTHOR]

ABSTRACT: The present study focuses on the effect of familiarity with different English accents. Specifically, the study investigates Japanese university students' intelligibility and comprehensibility judgements of familiar and unfamiliar English -- American English and Irish English, respectively. To see to what extent each variety was intelligible to them, subjects were asked to listen to self introductions of native speakers and fill missing words in blanks. To examine how comprehensible the varieties were, they were asked to indicate their judgements subjectively by using 7-point scales. Findings include: (1) Even if the listeners felt an utterance was easy to understand, it did not necessarily mean they could transcribe the words or understand the message correctly; (2) the amount of exposure and familiarity seemed to be factors contributing to higher perceived comprehensibility but not necessarily to better understanding of the message; and (3) listeners' perception of speech was likely to be affected by salient vocal features such as clarity, intonation, fluency and pauses. It is assumed that familiarity and exposure had at least a positive psychological effect on the listeners, which could lead to less inhibition, bias toward and more tolerance of different varieties of English. [ABSTRACT FROM AUTHOR]