Introduction: Epithelioid endothelial tumor (ETT) is an extremely rare tumor that typically occurs in women of reproductive age. The diagnosis tends to be delayed because it often necessitates a total hysterectomy. Therefore, it is important to understand ETT macroscopic and imaging findings. Here, we report a case of ETT with detailed macroscopic and imaging findings. Case Presentation: A 39-year-old woman with positive pregnancy test results was admitted to a nearby hospital. No gestational sac was found in the uterus, and magnetic resonance imaging (MRI) revealed a cystic mass of approximately 7 cm that extended continuously from the anterior wall of the lower uterine segment into the pelvic cavity. She underwent laparoscopic and hysteroscopic surgeries for a ruptured cervical pregnancy. Pathology of the specimens obtained from this surgery did not allow for the diagnosis of ETT. Two months after the surgery, as the serum human chorionic gonadotropin β subunit (β-HCG) level did not decrease, she was diagnosed with low-grade gestational trophoblastic neoplasia, leading to the administration of chemotherapy. After three regimens of chemotherapy over 9 months, her β-HCG level decreased but did not reach normal levels. Ultimately, a total hysterectomy was performed. The pathological diagnosis was mixed ETT and choriocarcinoma. A literature review revealed several cases similar to ours. Conclusion: ETT in the lower uterus often perforates the myometrium and forms cystic lesions in the retroperitoneal space or subserosa. The MRI and laparoscopic/hysteroscopic findings in this case may have contributed to the early diagnosis of ETT.

AimAdhesion after pelvic surgery causes infertility, ectopic pregnancy, and ileus or abdominal pain. The materials currently available for clinical use are insufficient. The purpose of this study was to develop an anti-adhesive material that overcomes the limitations of conventional anti-adhesive agents.MethodsThe adhesion prevention effects of three methods - a two-layered sheet composed of gelatin film and gelatin sponge, Seprafilm and INTERCEED - were evaluated in 37 dogs. Anti-adhesive effects were investigated macroscopically and microscopically in a cauterized uterus adhesion model. Cell growth on the materials in vitro using human peritoneal mesothelial cells, fibroblasts and uterine smooth muscle cells were also evaluated.ResultsThe two-layered gelatin sheet had significantly superior anti-adhesive effects compared to the conventional materials (Seprafilm and INTERCEED). A single-cell layer of mature mesothelium formed three weeks after surgery in the gelatin group. Peritoneum regeneration in the Seprafilm and INTERCEED groups was delayed and incomplete in the early phase. Little inflammation around the materials occurred and cell growth was significantly proliferated with the gelatin sheet.ConclusionThe anti-adhesive effects of a two-layered gelatin sheet were superior to conventional agents in a cauterized canine uterus model, demonstrating early regeneration of the peritoneum, little inflammation and material endurance. The newly developed two-layered gelatin sheet is a useful option as an anti-adhesive agent for deeply injured and hemorrhagic sites.

Peritoneal loose bodies (PLBs) are defined as fibrotic or calcified-free bodies within the peritoneal cavity; they commonly autoamputate from appendices epiploicae that have undergone torsion. Pedunculated, subserosal uterine leiomyomas (PSULs) are subserosal uterine leio- myomas connected to the uterus via a pedicle. In the present report, we describe the case of a PLB that origi- nated from the autoamputation of a PSUL, confirmed based on histological evidence consistent with a uterine leiomy- oma and the laparoscopic findings of a broken pedicle. This case clearly demonstrates the potential for a uterine leio- myoma to be the source of a PLB. Our findings contribute to the understanding of the etiological relationship between PLBs and uterine leiomyomas.

To generate a more effective and safer anti-adhesive material, we developed a new thermally cross-linked gelatin film. We previously reported that this film had superior anti-adhesive effects compared to cellulose film and could be used safely on the intestinal anastomosis in canine models. To evaluate the handling of the gelatin film during surgery, we investigated the physical properties of the gelatin film and compared it with cellulose film. We performed tensile and shear tests to evaluate the maximum loads, the elastic modulus and the fracture strains of the gelatin film, paying special attention to the relationship between the time required for the thermal cross-linking and those physical properties. The maximum tensile and shear loads of each thermally cross-linked gelatin film were significantly higher than those of cellulose film. The fracture strains of each gelatin film were also significantly higher than those of cellulose film. However, there were no significant differences in the elastic modulus between the gelatin films and the cellulose film in terms of both the tensile and shear tests. There were no significant differences in these physical properties among the gelatin films allowed to thermally cross-link for different lengths of time. In conclusion, thermally cross-linked gelatin film has a higher physical strength and ductility than cellulose film, regardless of the time allowed for thermal cross-linking. These physical properties of the gelatin films are considered to be advantageous for their handling during surgery.

We developed sheets of non-woven poly (glycolic acid) PGA fabric that can act as a scaffold to form smoothly dense granulation tissue for barrier walls to localize leakage of pancreatic juice. In this study, we tested three kinds of materials: poly (Llactide-e-caprolactone) (copolymer) film, PGA fabric-0.9 with a mean fiber diameter of 0.9μm and PGA fabric-20 with a mean fiber diameter of 20 μm. Under general anesthesia, the pancreatic surface of rats was cauterized with an electric scalpel. Then, the pancreas was wrapped with one of the three kinds of sheets and the sheet was fixed onto the surrounding tissues. Survival was observed for five days after surgery. The survival rates were higher in the two groups of fabric-treated rats than in the other groups, although the differences were significant only for the film-treated group. Macroscopically, severe pathologic findings such as accumulation of ascites, tumor formation in whole intraperitoneal organs and generalized peritonitis occurred at a significantly lower incidence in the two fabric-treated groups than in the film-treated group. Microscopically, granulation tissue was formed along the fabrics throughout the full thickness of the fabric scaffolds of fabric-0.9 and fabric-20. In these groups, injurious tissue changes and inflammatory reactions were reduced in the outer zone of the fabric wall compared to that observed in the inner zone. Therefore, the new PGA fabrics successfully localized pancreatic juice leakage. In contrast, in the no treatment group and the film-treated group, injurious tissue changes and severe inflammation were spread out to places distant from the cauterized pancreas. In the film-treated group in particular, the accumulation of mono nuclear inflammatory cells was spread along the film, even into the outer zone of the sheet, and granulation formation of a barrier wall was suppressed around the film. Therefore, in the film-treated group, tissue injury and inflammation caused by pancreatic juice extended more widely and granulation formation of a barrier wall was strongly suppressed, even compared with that observed in the no treatment group. In conclusion, these fabrics can be a more suitable and effective material for the treatment of leakage of pancreatic juice.

CytopathologyVolume 15, Issue 3 p. 171-172 Eosinophilic ascites: Taxol-induced hypersensitivity? T. K. Kobayashi, T. K. Kobayashi Departments of PathologySearch for more papers by this authorM. Muramatsu, M. Muramatsu Departments of PathologySearch for more papers by this authorM. Ueda, M. Ueda Departments of PathologySearch for more papers by this authorT. Nishino, T. Nishino Departments of PathologySearch for more papers by this authorM. Bamba, M. Bamba Departments of PathologySearch for more papers by this authorM. Urabe, M. Urabe Obstetrics and Gynecology, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, JapanSearch for more papers by this authorS. Moritani, S. Moritani Department of Pathology, National Nagoya Hospital, Aichi, JapanSearch for more papers by this author T. K. Kobayashi, T. K. Kobayashi Departments of PathologySearch for more papers by this authorM. Muramatsu, M. Muramatsu Departments of PathologySearch for more papers by this authorM. Ueda, M. Ueda Departments of PathologySearch for more papers by this authorT. Nishino, T. Nishino Departments of PathologySearch for more papers by this authorM. Bamba, M. Bamba Departments of PathologySearch for more papers by this authorM. Urabe, M. Urabe Obstetrics and Gynecology, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, JapanSearch for more papers by this authorS. Moritani, S. Moritani Department of Pathology, National Nagoya Hospital, Aichi, JapanSearch for more papers by this author First published: 26 May 2004 https://doi.org/10.1111/j.1365-2303.2004.00132.xCitations: 2 Dr. T.K. Kobayashi, Department of Pathology Saiseikai Shiga Hospital, Imperial Gift Foundation, Inc Ritto, Shiga 520-3046, Japan Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume15, Issue3June 2004Pages 171-172 RelatedInformation

The cytologic appearance of endosalpingiosis in peritoneal fluid cytology smears has not been extensively described. We report a case of endosalpingiosis in a 29‐year‐old pregnant female who presented with peritoneal fluid. Dense papillary epithelial clusters with indistinct ciliated cells were found in the Papanicolaou‐stained smears. However, long and delicate cilia were obvious in papillary cluster with scanning electron microscopy. Cell nuclei were oval, with finely dispersed chromatin and uniform nuclear membrane. Peritoneal fluid cytology with these findings may be helpful to suggest the probable preoperative diagnosis of endosalpingiosis or benign glandular inclusions involving the pelvic peritoneum. Diagn. Cytopathol. 2004;30:422–425. © 2004 Wiley‐Liss, Inc.

Uterine artery embolization (UAE) for the treatment of symptomatic uterine leiomyomata was first described in the French literature in 1991 by Ravina et al.10,11 Since then, UAE has been used with increasing frequency as a nonsurgical treatment for a variety of clinical conditions, including leiomyomata,3,10 adenomyosis1 and persistent hematoma.2 While several published reports4,9,12 describe the histopathologic effects of UAE on a uterine leiomyoma, there are no English-language reports on the cytologic changes in vaginal discharge after UAE for the treatment of myomata uteri. We had the opportunity to study such cases by cytology of vaginal discharge, and the utility of ancillary studies is also described. We retrieved the records for 20 UAE procedures performed between June and September 2001. Twenty patients, aged 33–50 years (mean, 42.7), with menorrhagia, uterine bleeding, pelvic pain and bulk-related symptoms related to uterine leiomyomata were included in this study. In each patient, a uterine leiomyoma > 10 mm in diameter, the location of the largest leiomyoma and the presence of a submucosal leiomyoma was assessed on baseline magnetic resonance imaging (MRI). No women had coexisting adenomyosis, as confirmed with baseline MRI. Before UAE, all the women were examined by a local gynecologist, and uterine leiomyomata were diagnosed. Most of the women had undergone an initial unsuccessful course of drug therapy. They were all instructed by gynecologists to undergo hysterectomy and myomectomy, but all refused such treatment. They were all informed of the benefits and risks of UAE. Oral and written informed consent was obtained from the women and their families. By means of the single femoral arterial approach, arteriography and embolization were performed with a digital angiographic unit, as described by Katsumori et al.6 Gelatin sponge particles (500–1,000 μm in diameter) were utilized as an embolic agent. Cytologic examination one day after embolization for the treatment of uterine leiomyomata was performed directly from the sanitary napkin by imprint smearing. A total of three cellular samples were obtained from each patient. After fixation with 95% ethanol, the smeared slides were stained by the modified Papanicolaou method. The clinical features, including size and location of uterine leiomyomata and color of the vaginal discharge with cytologic changes, in all 20 patients are summarized in Table I. A total of 51 samples were obtained from 17 cases. Ages ranged from 33 to 50 Acta Cytologica

Diagnostic CytopathologyVolume 27, Issue 2 p. 132-134 Letter to the Editor Effects of Taxol on ascites cytology from a patient with fallopian tube carcinoma: Report of a case with ultrastructural studies Tadao K. Kobayashi Ph.D., C.F.I.A.C., Tadao K. Kobayashi Ph.D., C.F.I.A.C. Department of Pathology, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, JapanSearch for more papers by this authorSuzuko Moritani M.D., Ph.D., Suzuko Moritani M.D., Ph.D. Department of Pathology, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, JapanSearch for more papers by this authorMasamichi Bamba M.D., Ph.D., Masamichi Bamba M.D., Ph.D. Department of Pathology, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, JapanSearch for more papers by this authorYoshinobu Fujimoto M.D., Yoshinobu Fujimoto M.D. Department of Obstetrics & Gynecology, Saiseikai Shiga Hospital, Imperial Gift Foundation, Inc., Shiga, JapanSearch for more papers by this authorMamoru Urabe M.D., Ph.D., Mamoru Urabe M.D., Ph.D. Department of Obstetrics & Gynecology, Saiseikai Shiga Hospital, Imperial Gift Foundation, Inc., Shiga, JapanSearch for more papers by this authorChiyuki Kaneko Ph.D., C.F.I.A.C., Chiyuki Kaneko Ph.D., C.F.I.A.C. Department of Cytology, Fujita Health University, Aichi, JapanSearch for more papers by this author Tadao K. Kobayashi Ph.D., C.F.I.A.C., Tadao K. Kobayashi Ph.D., C.F.I.A.C. Department of Pathology, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, JapanSearch for more papers by this authorSuzuko Moritani M.D., Ph.D., Suzuko Moritani M.D., Ph.D. Department of Pathology, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, JapanSearch for more papers by this authorMasamichi Bamba M.D., Ph.D., Masamichi Bamba M.D., Ph.D. Department of Pathology, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, JapanSearch for more papers by this authorYoshinobu Fujimoto M.D., Yoshinobu Fujimoto M.D. Department of Obstetrics & Gynecology, Saiseikai Shiga Hospital, Imperial Gift Foundation, Inc., Shiga, JapanSearch for more papers by this authorMamoru Urabe M.D., Ph.D., Mamoru Urabe M.D., Ph.D. Department of Obstetrics & Gynecology, Saiseikai Shiga Hospital, Imperial Gift Foundation, Inc., Shiga, JapanSearch for more papers by this authorChiyuki Kaneko Ph.D., C.F.I.A.C., Chiyuki Kaneko Ph.D., C.F.I.A.C. Department of Cytology, Fujita Health University, Aichi, JapanSearch for more papers by this author First published: 30 July 2002 https://doi.org/10.1002/dc.10144Citations: 7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume27, Issue2August 2002Pages 132-134 RelatedInformation

We describe the histopathologic features of uterine leiomyoma after uterine artery embolization (UAE) in a 42-year-old woman. This patient, who was taking antiplatelet drugs for the treatment of cerebral disease, successfully underwent UAE using only gelatin sponge particles for a symptomatic uterine leiomyoma. Although menorrhagia improved moderately after the procedure, she underwent abdominal hysterectomy 11 months later because of recurrent uterine bleeding. Histopathology revealed that most of the area of the uterine leiomyoma was characterized by extensive coagulation necrosis, which support the positive result of the procedure. No significant abnormalities were noted in either the myometrium or endometrium, which also suggested that UAE using only gelatin sponge particles is an appropriate procedure to preserve the uterus. The histologic and radiologic features of this case are discussed. To the best of our knowledge, this is the first reported case of uterine leiomyoma after UAE using only gelatin sponge particles as a primary embolic agent.

International Journal of Gynecology & ObstetricsVolume 70, Issue S2 p. B16-B16 Invited communication Long term effects of hrt on Alzheimer's disease H. Honio, H. HonioSearch for more papers by this authorN. Kikuchi, N. KikuchiSearch for more papers by this authorY. Kinoshita, Y. KinoshitaSearch for more papers by this authorT. Hosoda, T. HosodaSearch for more papers by this authorK. Kariya, K. KariyaSearch for more papers by this authorT. Tamura, T. TamuraSearch for more papers by this authorM. Urabe, M. UrabeSearch for more papers by this author H. Honio, H. HonioSearch for more papers by this authorN. Kikuchi, N. KikuchiSearch for more papers by this authorY. Kinoshita, Y. KinoshitaSearch for more papers by this authorT. Hosoda, T. HosodaSearch for more papers by this authorK. Kariya, K. KariyaSearch for more papers by this authorT. Tamura, T. TamuraSearch for more papers by this authorM. Urabe, M. UrabeSearch for more papers by this author First published: 10 December 2003 https://doi.org/10.1016/S0020-7292(00)86127-5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume70, IssueS22000Pages B16-B16 RelatedInformation

In 1997, the average life span for Japanese women was 83.82 years, the highest worldwide average for 13 years. However, sometimes the faces of Japanese women don’t look so well. Their quality of life is also very important. The second most common cause of death in women is cerebrovascular disease, and the third is heart disease. Both of these conditions are closely associated with arterial sclerosis (Table 1).

International Journal of Gynecology & ObstetricsVolume 70, Issue S4 p. D137-D137 Menopause Estrogen reduces the elevation of intracellular calcium concentration and cellular peroxidation induced by amyloid β protein T. Hosoda, T. HosodaSearch for more papers by this authorK. Kariya, K. KariyaSearch for more papers by this authorH. Tatsumi, H. TatsumiSearch for more papers by this authorH. Kojima, H. KojimaSearch for more papers by this authorC. Katoo, C. KatooSearch for more papers by this authorT. Okuda, T. OkudaSearch for more papers by this authorK. Tanaka, K. TanakaSearch for more papers by this authorT. Tamura, T. TamuraSearch for more papers by this authorM. Urabe, M. UrabeSearch for more papers by this authorH. Honjo, H. HonjoSearch for more papers by this author T. Hosoda, T. HosodaSearch for more papers by this authorK. Kariya, K. KariyaSearch for more papers by this authorH. Tatsumi, H. TatsumiSearch for more papers by this authorH. Kojima, H. KojimaSearch for more papers by this authorC. Katoo, C. KatooSearch for more papers by this authorT. Okuda, T. OkudaSearch for more papers by this authorK. Tanaka, K. TanakaSearch for more papers by this authorT. Tamura, T. TamuraSearch for more papers by this authorM. Urabe, M. UrabeSearch for more papers by this authorH. Honjo, H. HonjoSearch for more papers by this author First published: 11 December 2003 https://doi.org/10.1016/S0020-7292(00)84645-7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume70, IssueS42000Pages D137-D137 RelatedInformation

The metabolism of physiological concentrations (5 x 10(-9) M) of [3H]estrone (E1), [3H]estradiol (E2), and [3H]estrone sulfate (E1S) was studied in isolated fetal uterine and vaginal cells of guinea pigs in culture. After 24 hours of incubation in both cells, a large percentage (40-60%) of E1 is converted to E2; however, after incubation of E2, most of the radioactive material (45-65%) corresponds to unchanged E2. Similarly, in the incubation medium the concentration of E2 is significantly higher related to E1 after incubation with E1 or E2. An intense sulfotransferase activity is found for both estrogens, whereas in the culture medium the respective sulfates represent 27-45% of the total radioactive material after incubation with the uterine cells and 15-24% for the vaginal cells. Using E1S, significant hydrolysis is observed in both cells and the analysis of the freed radioactive material indicated a high percentage in E2 (66% in the uterine cells and 71% in the vaginal cells). The conversion of E1S to E2 was strongly decreased by the antiestrogens: tamoxifen, 4-hydroxy-tamoxifen, and ICI 164,384. The inhibitory effect in relation to the incubation with E1S only was 43-66% in the uterine cells and 50-85% in the vaginal cells. The present data suggest that estrogen sulfates can play an important biological role in the target tissues of the fetus, and that the enzymatic mechanisms of the bioavailability of E2 for the biological responses of the hormone can be operated in the target tissue itself.