Mai Kamoi

Expression of natural cytotoxicity receptors on peritoneal fluid natural killer cell and cytokine production by peritoneal fluid natural killer cell in women with endometriosis.

To investigate the relationship between the expression of natural cytotoxicity receptors (NCRs) on peritoneal fluid (PF) natural killer (NK) (pfNK) cells and cytokine production by pfNK cells in women with endometriosis.

Changes of NK Cells in Preeclampsia

The regulation of uterine and circulating peripheral blood natural killer (NK) cells has been associated with reproductive immunology such as recurrent pregnancy losses, implantation failures, or preeclampsia. Preeclampsia is a hypertensive disorder of pregnancy characterized by increased blood pressure accompanied by proteinuria and is a major cause of maternal and fetal mortality. Natural cytotoxicity receptors (NCRs) are unique markers, which regulate NK cell cytotoxicity and cytokine production. The relation of NCRs to reproduction is not fully characterized yet. The different profile of NCRs expression may suggest presence of abnormal regulation of NK cell in women with reproductive failures. Pregnant women with preeclampsia carry immunological abnormalities of NCRs on peripheral blood NK cells during pregnancy. The lower expression of NKp46+ NK cells in women with preeclampsia may account for the higher production of NK1 cytokine that is known as NK1 shift in pregnant women with preeclampsia. Evaluation of NKp46 on peripheral blood NK cells may be applicable to find the onset of preeclampsia. In this review, various expressions of NK cell surface markers including NCRs on NK cells, NK cell cytotoxicity, and production of cytokines and angiogenic factors by NK cells were reviewed in relation to preeclampsia.

Role of NKp46 Expression in Cytokine Production by CD56-Positive NK Cells in the Peripheral Blood and the Uterine Endometrium

To investigate the role of natural cytotoxicity receptor, NKp46 expression in cytokine‐producing NK cells.

NK22 Cells in the Uterine Mid-Secretory Endometrium and Peripheral Blood of Women with Recurrent Pregnancy Loss and Unexplained Infertility

We aimed to investigate natural killer 22 (NK22) cells in the peripheral blood and the uterine endometrium of women with unexplained recurrent pregnancy loss (URPL) and unexplained infertility (UI).

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.

NK cell abnormality and its treatment in women with reproductive failures such as recurrent pregnancy loss, implantation failures, preeclampsia, and pelvic endometriosis

The regulation of uterine and peripheral blood natural killer (NK) cells has been associated with problems related to reproductive immunology such as recurrent pregnancy loss (RPL), implantation failure or preeclampsia. NKp46, one of the natural cytotoxicity receptors (NCRs), is a unique marker that functions in NK cell cytotoxicity and cytokine production. Expression of NKp46 on NK cells is lower in women with recurrent pregnancy loss and pregnancy-induced hypertension. Moreover, expression of NKp46 on peritoneal fluid NK cells is lower in women with pelvic endometriosis. Therefore, evaluation of NKp46 on peripheral blood NK cells may provide a means of screening for reproductive abnormalities. Recently, a new type of NK cell, the NK22 cell, has been reported. This cell may be a regulator not only of the mucosal barrier but also of reproduction.For women with RPL showing abnormal uterine and/or peripheral blood NK cells, both intravenous immunoglobulin treatment and intralipid treatment have been reported. The effects of these treatments are still controversial, and further studies are needed in order to clarify their true impact. The present review examines variations in the expression of NCRs on NK cells, the participation of NK22 cells in reproduction, and the possible use of intravenous immunoglobulin or intralipid treatment for women with recurrent pregnancy loss and NK cell abnormality.

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