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Aim: Uterine atony is a major cause of postpartum hemorrhage. We recently proposed a new concept for the histopathophysiology of refractory uterine atony, postpartum acute myometritis (PAM), characterized by acute inflammatory changes with massive stromal edema, increased numbers of complement C5a receptors and diffuse mast cell activation in the myometrium. We herein focused on the possible involvement of the kinin‐kallikrein system in the rapid development of interstitial edema in PAM, particularly bradykinin receptor type 1 (B1R), which is up‐regulated under inflammatory conditions. The present study investigated B1R expression with uterine interstitial edema in PAM. Methods: Our institution plays an important role in a Japanese amniotic fluid embolism registry project. We selected PAM cases from uterine samples delivered to us for further analyses between 2012 and 2017. Control tissues were collected during cesarean section and planned hysterectomy. B1R expression was semi‐quantitatively measured by immunohistochemistry, while uterine interstitial edema was estimated by semi‐quantitative measurements of the alpha smooth muscle actin‐negative area using immunohistochemistry. Results: There were 36 and 8 cases in the PAM and control groups, respectively. The alpha smooth muscle actin‐negative area was increased in the PAM group, concomitant with the significant up‐regulation of B1R expression in uterine smooth muscle cells, vascular endothelial cells, and neutrophils. A positive correlation was observed between these two factors. Conclusion: We demonstrated the up‐regulated expression of B1R in the myometrium and its positive correlation with histologically estimated interstitial edema, suggesting the contribution of the kinin‐kallikrein‐B1R system to the development of interstitial edema in PAM cases. [ABSTRACT FROM AUTHOR]

Short-chain fatty acids (SCFAs) produced by fermentation from prebiotics not only provide energy but also activate cell membrane receptors, thereby contributing to the maintenance of homeostasis in the human body. Recently, free fatty acid receptor 2 (FFAR2), which uses SCFAs as ligands, was found to exert oncoprotective effects on several types of neoplasia. This study examined whether SCFAs have oncoprotective effects on uterine cervical neoplasia. Immunohistochemical analysis revealed that FFAR2 was expressed in atypical cells and cancer cells of cervical neoplasia. Moreover, reverse transcription polymerase chain reaction showed that FFAR2 was expressed in a human cervical cancer cell line, HeLa. We also found that SCFAs inhibited the proliferation of HeLa cells, and a FFAR2 antagonist, GLPG0974, used to suppress the binding of SCFAs significantly restored the cell viability of HeLa cells blocked by acetic acid treatment. These results suggest that ingestion of prebiotics and the resulting production of SCFAs may play an oncoprotective role against uterine cervical neoplasia via FFAR2 expression. [ABSTRACT FROM AUTHOR]

Intravenous leiomyomatosis (IVL) is a rare benign tumor. The clinical behavior can be life-threatening due to extension through the pelvic veins. A 70-year-old woman was referred to our hospital with IVL originating from a uterine leiomyoma and extending to the inferior vena cava. The patient was diagnosed on the basis of the results of various studies, and the tumor was resected completely through a single-stage approach. The intravascular tumor was 20 cm long, multinodular and rubbery. Microscopic findings showed benign smooth muscle that was partly hyalinized and fibrous. Immunohistochemical studies revealed that hyaluronan was expressed more prominently in IVL than in uterine leiomyomas. IVL has viscoelastic properties and contains a large amount of hyaluronan, which may promote invasion during pathogenesis. [ABSTRACT FROM AUTHOR]

Cases of cancer presenting with microscopically confirmed metastatic malignancies for which no primary site can be detected are a challenge to stage clinically. Adenocarcinoma of unknown primary site is a subtype with high frequency that has no standard treatment and a poor prognosis. A 32-year-old female was found to have a tumor in the abdominal wall. Tumorectomy was conducted. A pathological examination indicated serous papillary adenocarcinoma, and peritoneal or ovarian cancer was suspected. Exploratory laparotomy and partial resection of the ovaries were carried out, but there were no malignant findings in the peritoneum, ovarian tissue or ascitic fluid. This is an extremely rare case of serous papillary adenocarcinoma with a cystic tumor that was categorized as extraovarian peritoneal serous papillary carcinoma (EPSPC) without other clinical findings. [ABSTRACT FROM AUTHOR]

Background. The purpose of this study was to examine whether EP4 as prostaglandin (PG) E2 receptor is involved in lipopolysaccharide (LPS)-induced cervical ripening. Methods. New Zealand White non-pregnant rabbits were randomly allocated to 4 equal groups and treated with vaginal suppositories containing LPS with various concentrations of EP4-selective antagonist once daily for 3 days, and then sacrificed for analysis. Analysis was performed in order to examine the inhibitory effect of EP4 antagonist on LPS-induced cervical ripening. The expression of EP4 in a cervix treated with LPS was examined immunohistochemically. The percent of cervical extensibility in the segment of cervix as the tensile strength was determined with 5.8 g of constant perpendicular stretching. The ripening area of the cervix with edematous changes in H&E sections was calculated by a microscopic system with a computer-assisted digital analyser. Type-1 collagenase activity was determined in cervical tissue using FITC-labelled type-1 collagen. Results. Immunohistochemical study shows the positive staining of EP4 at the interstitial cells in the cervix treated with LPS. The extensibility, cervical edematous area and type-1 collagenase activity are significantly reduced in the cervix treated with LPS in the presence of EP4 antagonist compared with that treated with LPS alone. Conclusions. These data implicates the EP4 as the PGE2 receptor involved in LPS-induced cervical ripening. [ABSTRACT FROM AUTHOR]

Summary Plasma cells play a pivotal role in the immune system and areresponsible for the synthesis and release of immunoglobulins. Numerous invitro culture experiments on the yolk sac demonstrated the generationof mature cells of the myeloid and lymphoid lineages under appropriateculture conditions. However, there are no reports describing thedevelopment of mature lymphoid cells in the yolk sac so far. Forthis reason, we undertook this study to investigate the developmentof antibody-containing plasma cells during early yolk sac haematopoiesis. Immunohistochemistryand immunoelectron microscopy were employed in the study. Resultsof this work demonstrated very weak immune staining for the intracytoplasmicIgA, IgG, and IgM at days 10 and 11 of embryonic life, while darkstaining was obtained at 12 days. Positive staining was localizedto the endodermal cell layer. Electron microscopic examinationsrevealed the existence of cells with the typical characteristicsof plasma cells inside the endodermal cell layer, which may suggesttheir endodermal origin. To further verify the nature of these cells,intracytoplasmic immunoglobulins were demonstrated by immunoelectronmicroscopy. The present study demonstrated emergence of mature functioningplasma cells in early rat yolk sac. In a previous work we hypothesizedthe possibility of endodermal origin of yolk sac macrophages. Thisstudy adds additional evidence to support that hypothesis. The possiblerole of plasma cells in the yolk sac is discussed. [ABSTRACT FROM AUTHOR]