Ayako Taima

Expression of retinoid‐related orphan receptor (ROR)γt on NK22 cells in the peripheral blood and uterine endometrium of women with unexplained recurrent pregnancy loss and unexplained infertility

Recently, NK22 cells, a subset of interleukin (IL)‐22‐producing natural killer (NK) cells, were identified. We have previously reported the higher percentage of NK22 cells in women suffering recurrent pregnancy loss (RPL). Moreover, we have also reported lower expression of NKp46, a kind of natural cytotoxicity receptor (NCR), on NK cells and the changes of NK cell producing cytokines in women who experience RPL. NK22 cells express NCRs, such as NKp44 or NKp46. Retinoid‐related orphan receptor γt (RORγt) is known as a regulator of NK22 cells; however, in NK22 cells of peripheral blood (PB) and the uterine endometrium (UE), the relationship between NCRs and RORγt is unclear. We investigate RORγt expression NK22 cells in the PB and UE of women with unexplained infertility (uI) or unexplained RPL (uRPL).

Functional Role of Uterine Natural Killer Cells

The most abundant cells in the uterine endometrium (from the secretory phase to the stage of early-pregnancy decidua) are natural killer (NK) cells. Endometrial (uterine) NK cells and decidual NK cells are phenotypically and functionally different from peripheral blood NK cells.

Broken tip of mono-polar surgery probe located in the abdominal wall after laparoscopically assisted myomectomy: A case report

Incidents involving the breakage of operative instruments occurs in 0.07% of surgeries.1 We experienced a case of a broken operative instrument left in the abdominal wall. A 36-year-old woman was admitted to our hospital for primary infertility. We performed an infertility screening including hysterosalpingography (HSG). The patient was found to havemultiple uterine myomas and left hydrosalpinx. At that time, no abnormal shadows were found in the abdominal wall. The patients height was 158 cm and weight was 53.5 kg. Laparoscopically assisted myomectomy and left salpingectomy were performed. Three suprapubic ancillary ports were inserted as follows: lateral side ports were inserted at 5 mm bilaterally near the anterior superior iliac spines; transverse incision for the central port was set at 3 cm; and myomectomy and uterine suturing were performed using the central port. The peritoneal cavity was washed using an Endopath surgery probe (Ethicon, Tokyo, Japan; Figure 1A). A follow-up HSG was performed 1 month after the surgery and showed a normal shaped uterus and spill into the right tube. At that time, a ski-shaped shadow was visualized in the right flank (Figure 2A); however, we could not identify it. After the surgery, the patient conceived by in vitro fertilization and embryo transfer, and was referred to the obstetrical clinic at 10 weeks of pregnancy. The pregnancy course was uneventful and she delivered at full term by a cesarean section due to the history of myomectomy. A follow-up radiographic imagewas obtained after the cesarean section to scan for intra-abdominal foreign bodies, such as gauze. A 3-cm ski-shaped shadow was visualized at the right flank (Figure 2B), and the same was visualized using computed tomography (Figure 2C). The foreign body was located in the subcutaneous region. This was 7 years after the laparoscopic surgery. The foreign body was removed with radiographic assistance. It was not a sharp needle, but a 3-cm blunt metallic object, which was identified as the tip of the broken Endopath surgery probe (Ethicon; Figure 1). Despite reviewing the record of this surgery, we could not detect the broken part of the mono-polar surgery probe which would