Chronic endometritis (CE) is a localized mucosal infectious and inflammatory disorder marked by infiltration of CD138(+) endometrial stromal plasmacytes (ESPC). CE is drawing interest in the field of reproductive medicine because of its association with female infertility of unknown etiology, endometriosis, repeated implantation failure, recurrent pregnancy loss, and multiple maternal/newborn complications. The diagnosis of CE has long relied on somewhat painful endometrial biopsy and histopathologic examinations combined with immunohistochemistry for CD138 (IHC-CD138). With IHC-CD138 only, CE may be potentially over-diagnosed by misidentification of endometrial epithelial cells, which constitutively express CD138, as ESPCs. Fluid hysteroscopy is emerging as an alternative, less-invasive diagnostic tool that can visualize the whole uterine cavity in real-time and enables the detection of several unique mucosal findings associated with CE. The biases in the hysteroscopic diagnosis of CE; however, are the inter-observer and intra-observer disagreements on the interpretation of the endoscopic findings. Additionally, due to the variances in the study designs and adopted diagnostic criteria, there exists some dissociation in the histopathologic and hysteroscopic diagnosis of CE among researchers. To address these questions, novel dual immunohistochemistry for CD138 and another plasmacyte marker multiple myeloma oncogene 1 are currently being tested. Furthermore, computer-aided diagnosis using a deep learning model is being developed for more accurate detection of ESPCs. These approaches have the potential to contribute to the reduction in human errors and biases, the improvement of the diagnostic performance of CE, and the establishment of unified diagnostic criteria and standardized clinical guidelines for the disease.
Objectives: Recent studies focus on immunological, infectious, and inflammatory aspects of endometriosis. Meanwhile, chronic endometritis (CE) is an immunological, infectious, and inflammatory disorder of the eutopic endometrium with unusual stromal plasmacyte infiltration. Mechanism: In this review article, we aimed to gain a better understanding of the relationships between endometriosis and CE. Findings in Brief: Accumulating evidence supports the idea that CE is associated with infertility of unknown etiology, repeated implantation failure in an in vitro fertilization-embryo transfer program, recurrent pregnancy loss, as well as several perinatal/neonatal complications. Endometrial biopsy/histopathologic examinations and/or hysteroscopy are required to make a definitive diagnosis of CE. Conclusions: While endometriosis has been long considered a cause of infertility, CE is also an emerging issue that may reduce fecundity in women of reproductive age. Endometriosis and CE share characteristics of endometrial proliferative nature. The potential relationships between these two diseases of the uterine lining warrant future studies.
Since the 1964 Niigata Earthquake, the damages to pile foundations for bridges and buildings by the lateral flow have been reported in many large earthquakes in Japan. And the mechanism and the counter measure to this type of damage have been investigated. On the other hand, in the reality of lateral flow of liquefied ground, the grounds are usually covered with solidified thin surface layer due to plants' rooting or artificial solidification for pavement. If the surface layer is impermeable, the liquefaction phenomenon would be enhanced. Moreover, since the surface layer would not lose its stiffness even in the process of lateral flow, pile foundations must be subjected to extraordinary thrust from the surface layer. However, the effect of the surface non-liquefaction layer has not been concerned sufficiently in their investigations. A series of shaking table tests was conducted on three types of model sloping ground with a pile foundation. This study aims to reveal the mechanism of damage to the pile foundation induced by the lateral flow of liquefied sloping ground, with special attention on the interaction among the pile foundation, the liquefaction ground and the surface non-liquefaction layer. As the result of comparative examination of the observed behaviors, the significant combined effect of surface non-liquefaction layer and lateral flow on the damage to pile foundation was clarified.
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