Scholars@Duke
Danny J Schust

Danny J Schust

Edwin Crowell Hamblen Distinguished Professor of Reproductive Biology and Family Planning
Obstetrics and Gynecology, Reproductive Endocrinology & Infertility

Selected Publications

Pregnancies at the Uterotubal Junction: A Review of Terminology (Interstitial, Cornual, and Angular) and Recommendations for Management.

Journal Article Reprod Sci · September 2024 Ectopic pregnancies are one of the most common causes of obstetric mortality worldwide. Interstitial ectopic pregnancies, defined as an extracavitary pregnancy within the portion of the Fallopian tube that transverses the myometrium, have reported mortalit ... Full text Link to item Cite

Obstructive sleep apnea in pregnancy: A review of the literature from the obstetrics practitioner's view and a proposed clinical approach.

Journal Article Eur J Obstet Gynecol Reprod Biol · September 2024 Obstructive sleep apnea (OSA) is a frequent condition during pregnancy and its occurrence is increased in obese women. There are growing concerns about both pre-existing OSA and the development of gestational OSA and their effect on maternal pregnancy outc ... Full text Link to item Cite

Immune Checkpoint Molecules and Maternal–Fetal Immunity

Journal Article Current Obstetrics and Gynecology Reports · February 11, 2024 Full text Open Access Cite

Luteal Phase Defects and Progesterone Supplementation.

Journal Article Obstet Gynecol Surv · February 2024 IMPORTANCE: Luteal phase defects (LPDs), or an insufficiency of progesterone production during the luteal phase of the menstrual cycle, have been identified as a potential cause of recurrent pregnancy loss (RPL), but its exact contribution to RPL is not we ... Full text Link to item Cite

Controlling Trophoblast Cell Fusion in the Human Placenta-Transcriptional Regulation of Suppressyn, an Endogenous Inhibitor of Syncytin-1.

Journal Article Biomolecules · November 7, 2023 Cell fusion in the placenta is tightly regulated. Suppressyn is a human placental endogenous retroviral protein that inhibits the profusogenic activities of another well-described endogenous retroviral protein, syncytin-1. In this study, we aimed to elucid ... Full text Open Access Link to item Cite

In Reply.

Journal Article Obstet Gynecol · November 1, 2023 Full text Link to item Cite

Phase I and II randomized clinical trial of an oral therapeutic vaccine targeting human papillomavirus for treatment of cervical intraepithelial neoplasia 2 and 3.

Journal Article JNCI Cancer Spectr · October 31, 2023 BACKGROUND: Although many human papillomavirus (HPV)-targeted therapeutic vaccines have been examined for efficacy in clinical trials, none have been translated into clinical use. These previous agents were mostly administered by intramuscular or subcutane ... Full text Link to item Cite

Reproductive Scientist Development Program: Bridging the Gap to the Physician Scientist Career.

Journal Article Reprod Sci · September 2023 Career development awards are a successful strategy to facilitate the advancement of physician-scientists trained in obstetrics and gynecology (OBGYN) toward a path of investigative independence. While these funding mechanisms can be effective approaches t ... Full text Open Access Link to item Cite

Prenatal delta-9-tetrahydrocannabinol exposure is associated with changes in rhesus macaque DNA methylation enriched for autism genes.

Journal Article Clin Epigenetics · July 6, 2023 BACKGROUND: With the growing availability of cannabis and the popularization of additional routes of cannabis use beyond smoking, including edibles, the prevalence of cannabis use in pregnancy is rapidly increasing. However, the potential effects of prenat ... Full text Link to item Cite

Evaluation of a New Model for Human Chorionic Gonadotropin Rise in Pregnancies of Unknown Viability.

Journal Article Obstet Gynecol · July 1, 2023 OBJECTIVE: To evaluate the performance of a new human chorionic gonadotropin (hCG) threshold model to classify pregnancies as viable or nonviable using a longitudinal cohort of individuals with pregnancy of unknown viability. The secondary objective was to ... Full text Link to item Cite

Cannabis and Pregnancy: A Review.

Journal Article Obstet Gynecol Surv · July 2023 IMPORTANCE: Prenatal cannabis use is rising and is a major public health issue. Cannabis use in pregnancy and during lactation has been associated with increased maternal and offspring morbidity and mortality. OBJECTIVE: This review aims to summarize the e ... Full text Link to item Cite

Basolateral secretions of human endometrial epithelial organoids impact stromal cell decidualization.

Journal Article Mol Hum Reprod · April 3, 2023 Uterine glands and, by inference, their secretions impact uterine receptivity, blastocyst implantation, stromal cell decidualization, and placental development. Changes in gland function across the menstrual cycle are primarily governed by the steroid horm ... Full text Link to item Cite

An epigenetic synopsis of parental substance use.

Journal Article Epigenomics · April 2023 The rate of substance use is rising, especially among reproductive-age individuals. Emerging evidence suggests that paternal pre-conception and maternal prenatal substance use may alter offspring epigenetic regulation (changes to gene expression without mo ... Full text Link to item Cite

The immune checkpoint molecule, VTCN1/B7-H4, guides differentiation and suppresses proinflammatory responses and MHC class I expression in an embryonic stem cell-derived model of human trophoblast.

Journal Article Front Endocrinol (Lausanne) · 2023 The placenta acts as a protective barrier to pathogens and other harmful substances present in the maternal circulation throughout pregnancy. Disruption of placental development can lead to complications of pregnancy such as preeclampsia, intrauterine grow ... Full text Open Access Link to item Cite

Involvement of the HERV-derived cell-fusion inhibitor, suppressyn, in the fusion defects characteristic of the trisomy 21 placenta.

Journal Article Sci Rep · June 22, 2022 Suppressyn (SUPYN) is the first host-cell encoded mammalian protein shown to inhibit cell-cell fusion. Its expression is restricted to the placenta, where it negatively regulates syncytia formation in villi. Since its chromosomal localization overlaps with ... Full text Open Access Link to item Cite

Leveraging Optimized Transcriptomic and Personalized Stem Cell Technologies to Better Understand Syncytialization Defects in Preeclampsia

Journal Article Frontiers in Genetics · March 30, 2022 Understanding the process of human placentation is important to the development of strategies for treatment of pregnancy complications. Several animal and in vitro human model systems for the general study human placentation have been used. The field has e ... Full text Cite

Modeling the Human Placenta to Investigate Viral Infections During Pregnancy

Journal Article Frontiers in Virology · January 1, 2022 Throughout gestation, the placenta is vital for proper development of the fetus. Disruptions in trophoblast, the main functional cell type of the placenta, stress the pregnancy, with potential adverse outcomes for both mother and baby. While the placenta t ... Full text Cite

Placental Expression of ACE2 and TMPRSS2 in Maternal Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Are Placental Defenses Mediated by Fetal Sex?

Journal Article J Infect Dis · December 8, 2021 BACKGROUND: Expression of angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), host molecules required for viral entry, may underlie sex differences in vulnerability to severe acute respiratory syndrome coronavirus 2 ... Full text Open Access Link to item Cite

Is SARS-CoV-2 Infection a Risk Factor for Early Pregnancy Loss? ACE2 and TMPRSS2 Coexpression and Persistent Replicative Infection in Primitive Trophoblast.

Journal Article J Infect Dis · December 8, 2021 BACKGROUND: SARS-CoV-2 infection in term placenta is rare. However, growing evidence suggests that susceptibility of the human placenta to infection may vary by gestational age and pathogen. For several viral infections, susceptibility appears to be greate ... Full text Open Access Link to item Cite

Placental structural abnormalities in gestational diabetes and when they develop: A scoping review.

Journal Article Placenta · December 2021 Gestational diabetes mellitus (GDM) is defined as diabetes with onset or first recognition during gestation. It is a common complication of pregnancy that has become more prevalent over the past few decades. Abnormalities in fetal growth, including increas ... Full text Link to item Cite

Maternal SARS-CoV-2 infection elicits sexually dimorphic placental immune responses.

Journal Article Sci Transl Med · October 27, 2021 There is a persistent bias toward higher prevalence and increased severity of coronavirus disease 2019 (COVID-19) in males. Underlying mechanisms accounting for this sex difference remain incompletely understood. Interferon responses have been implicated a ... Full text Open Access Link to item Cite

Could the Human Endogenous Retrovirus-Derived Syncytialization Inhibitor, Suppressyn, Limit Heterotypic Cell Fusion Events in the Decidua?

Journal Article Int J Mol Sci · September 23, 2021 Proper placental development relies on tightly regulated trophoblast differentiation and interaction with maternal cells. Human endogenous retroviruses (HERVs) play an integral role in modulating cell fusion events in the trophoblast cells of the developin ... Full text Open Access Link to item Cite

Syncytins expressed in human placental trophoblast.

Journal Article Placenta · September 15, 2021 Three versions of syncytiotrophoblast exist in the human placenta: an invasive type associated with the implanting conceptus, non-invasive villous type of definitive placenta, and placental bed giant cells. Syncytins are encoded by modified env genes of en ... Full text Link to item Cite

Single Nucleus RNA Sequence (snRNAseq) Analysis of the Spectrum of Trophoblast Lineages Generated From Human Pluripotent Stem Cells in vitro

Journal Article Frontiers in Cell and Developmental Biology · July 21, 2021 One model to study the emergence of the human trophoblast (TB) has been the exposure of pluripotent stem cells to bone morphogenetic protein 4 (BMP4) in presence of inhibitors of ACTIVIN/TGFB; A83–01 and FGF2; PD173074 (BAP), which generates a mixture of c ... Full text Cite

Modeling human peri-implantation placental development and function†.

Journal Article Biol Reprod · July 2, 2021 It is very difficult to gain a better understanding of the events in human pregnancy that occur during and just after implantation because such pregnancies are not yet clinically detectable. Animal models of human placentation are inadequate. In vitro mode ... Full text Link to item Cite

Recombinant Thrombomodulin Attenuates Preeclamptic Symptoms by Inhibiting High-Mobility Group Box 1 in Mice.

Journal Article Endocrinology · April 1, 2021 Preeclampsia (PE) is a common gestational complication that involves systemic endothelial dysfunction and inflammatory responses primarily due to placental damage. Recombinant thrombomodulin (rTM), a novel anticoagulant clinically used for disseminated int ... Full text Link to item Cite

Sexually dimorphic placental responses to maternal SARS-CoV-2 infection.

Journal Article bioRxiv · March 29, 2021 There is a persistent male bias in the prevalence and severity of COVID-19 disease. Underlying mechanisms accounting for this sex difference remain incompletely understood. Interferon responses have been implicated as a modulator of disease in adults, and ... Full text Link to item Cite

In vitro models of the human endometrium: evolution and application for women's health.

Journal Article Biol Reprod · February 11, 2021 The endometrium is the inner lining of the uterus that undergoes complex regeneration and differentiation during the human menstrual cycle. The process of endometrial shedding, regeneration, and differentiation is driven by ovarian steroid hormones and pre ... Full text Link to item Cite

The Immunology of Syncytialized Trophoblast.

Journal Article Int J Mol Sci · February 10, 2021 Multinucleate syncytialized trophoblast is found in three forms in the human placenta. In the earliest stages of pregnancy, it is seen at the invasive leading edge of the implanting embryo and has been called primitive trophoblast. In later pregnancy, it i ... Full text Open Access Link to item Cite

Use of a human embryonic stem cell model to discover GABRP, WFDC2, VTCN1 and ACTC1 as markers of early first trimester human trophoblast.

Journal Article Mol Hum Reprod · June 1, 2020 Human placental development during early pregnancy is poorly understood. Many conceptuses are lost at this stage. It is thought that preeclampsia, intrauterine growth restriction and other placental syndromes that manifest later in pregnancy may originate ... Full text Link to item Cite

Refining Angular Pregnancy Diagnosis in the First Trimester: A Case Series of Expectant Management.

Journal Article Obstet Gynecol · January 2020 OBJECTIVE: To describe the natural history and outcomes of a large cohort of expectantly managed angular pregnancies diagnosed in the first trimester by specific ultrasound criteria. METHODS: We conducted a prospective case series of women with prenatally ... Full text Link to item Cite

Suppressyn localization and dynamic expression patterns in primary human tissues support a physiologic role in human placentation.

Journal Article Sci Rep · December 20, 2019 We previously identified suppressyn (SUPYN), a placental protein that negatively regulates the cell fusion essential for trophoblast syncytialization via binding to the trophoblast receptor for syncytin-1, ASCT2, and hypothesized that SUPYN may thereby reg ... Full text Open Access Link to item Cite

Self-renewing endometrial epithelial organoids of the human uterus.

Journal Article Proc Natl Acad Sci U S A · November 12, 2019 The human endometrium is essential in providing the site for implantation and maintaining the growth and survival of the conceptus. An unreceptive endometrium and disrupted maternal-conceptus interactions can cause infertility due to pregnancy loss or late ... Full text Link to item Cite

Placental expression of lysophosphatidic acid receptors in normal pregnancy and preeclampsia.

Journal Article Am J Reprod Immunol · November 2019 PROBLEM: Recent advances in lipid research have revealed that impairments in lipid mediator signaling can be involved in the pathoetiology of a variety of diseases. We previously reported aberrant expression of autotaxin, a key enzyme for lysophosphatidic ... Full text Link to item Cite

Modeling the Placenta with Stem Cells.

Journal Article N Engl J Med · October 24, 2019 Full text Link to item Cite

Early onset preeclampsia in a model for human placental trophoblast.

Journal Article Proc Natl Acad Sci U S A · March 5, 2019 We describe a model for early onset preeclampsia (EOPE) that uses induced pluripotent stem cells (iPSCs) generated from umbilical cords of EOPE and control (CTL) pregnancies. These iPSCs were then converted to placental trophoblast (TB) representative of e ... Full text Open Access Link to item Cite

Effects of three long-acting reversible contraceptive methods on HIV target cells in the human uterine cervix and peripheral blood.

Journal Article Reprod Biol Endocrinol · February 22, 2019 BACKGROUND: Hormonal contraceptives, particularly depot medroxyprogesterone acetate (DMPA), have been reported to be associated with substantially enhanced HIV acquisition; however, the biological mechanisms of this risk remain poorly understood. We aimed ... Full text Open Access Link to item Cite

Cervical and systemic concentrations of long acting hormonal contraceptive (LARC) progestins depend on delivery method: Implications for the study of HIV transmission.

Journal Article PLoS One · 2019 Progestin-only long-acting reversible contraceptives (LARCs) are increasingly popular among women seeking contraception; however, recent epidemiological studies suggest that systemically administered medroxyprogesterone acetate (MPA) may increase HIV acqui ... Full text Open Access Link to item Cite

Immunology and Reproduction

Chapter · January 1, 2019 The relationship between a living organism and its environment is based on a tightly regulated balance between symbiosis and competition. The complexity of an organism is directly correlated to the sheer volume of challenges presented to its continued fert ... Full text Cite

The National Physicians Cooperative: transforming fertility management in the cancer setting and beyond.

Journal Article Future Oncol · December 2018 Once unimaginable, fertility management is now a nationally established part of cancer care in institutions, from academic centers to community hospitals to private practices. Over the last two decades, advances in medicine and reproductive science have ma ... Full text Open Access Link to item Cite

Tokishakuyakusan, a traditional Japanese medicine (Kampo) mitigates iNKT cell-mediated pregnancy loss in mice.

Journal Article Am J Reprod Immunol · October 2018 OBJECTIVE: Tokishakuyakusan (TSS) is a traditional herbal medicine that has been used empirically to prevent recurrent pregnancy loss. Its mode of action remains unclear. With their potent capacity to produce cytokines, invariant natural killer (iNKT) cell ... Full text Link to item Cite

Chlamydia trachomatis-infected cells and uninfected-bystander cells exhibit diametrically opposed responses to interferon gamma.

Journal Article Sci Rep · May 31, 2018 The intracellular bacterial pathogen, Chlamydia trachomatis, is a tryptophan auxotroph. Therefore, induction of the host tryptophan catabolizing enzyme, indoleamine-2,3-dioxgenase-1 (IDO1), by interferon gamma (IFNγ) is one of the primary protective respon ... Full text Open Access Link to item Cite

Impact of Th1/Th2 cytokine polarity induced by invariant NKT cells on the incidence of pregnancy loss in mice.

Journal Article Am J Reprod Immunol · March 2018 OBJECTIVE: This study aimed to investigate the association of Th1/Th2 polarity induced by CD1d-restricted invariant natural killer T (iNKT) cells with pregnancy outcome. METHODS: Two types of iNKT cell stimulants with different cytokine induction propertie ... Full text Link to item Cite

Endocrinology of pregnancy

Chapter · January 1, 2018 The maternal-placental-fetal unit undergoes complex hormonal changes throughout pregnancy. Placental hormones dramatically adapt the endocrine physiology of the maternal host and lead to alterations in thyroid function, hypothalamic-pituitary-adrenal axis ... Full text Cite

African and Asian strains of Zika virus differ in their ability to infect and lyse primitive human placental trophoblast.

Journal Article PLoS One · 2018 Zika virus (ZIKV) drew worldwide attention when a recent epidemic was linked to fetal microcephaly. Here we used human embryonic stem cell derived trophoblasts as a model for primitive placental trophoblast to test the hypothesis that there are differences ... Full text Open Access Link to item Cite

A multi-omics informatics approach for identifying molecular mechanisms and biomarkers in clinical patients with endometriosis

Conference Proceedings - 2017 IEEE International Conference on Bioinformatics and Biomedicine, BIBM 2017 · December 15, 2017 Endometriosis is a complex gynecological disorder. The diagnostic process of endometriosis involves an invasive procedure thus delaying the diagnosis for about 10 years on average. Both DNA-methylation data and RNA-seq data has the potential to uncover mol ... Full text Cite

Labor prediction based on the expression patterns of multiple genes related to cervical maturation in human term pregnancy.

Journal Article Am J Reprod Immunol · November 2017 PROBLEM: This study explored the possibility of evaluating cervical maturation using swabbed cervical cell samples at term pregnancy, and aimed to develop a novel approach to predict labor onset. METHOD OF STUDY: Women with uncomplicated pregnancies (n=117 ... Full text Link to item Cite

Enhanced HIF2α expression during human trophoblast differentiation into syncytiotrophoblast suppresses transcription of placental growth factor.

Journal Article Sci Rep · September 29, 2017 Placental growth factor (PlGF), abundantly produced from trophoblasts is involved in placental angiogenesis. The regulatory mechanism of its expression is poorly understood. Hypoxia inducible factors (HIFs) are centrally involved in the modulation of cellu ... Full text Open Access Link to item Cite

Regulatory T cells decrease invariant natural killer T cell-mediated pregnancy loss in mice.

Journal Article Mucosal Immunol · May 2017 Pregnancy loss is the commonest complication of pregnancy. The causes of pregnancy loss are poorly understood. It has been reported that stimulation of invariant natural killer T (iNKT) cells using α-galactosylceramide (αGC) induces pregnancy loss in mice. ... Full text Link to item Cite

Vulnerability of primitive human placental trophoblast to Zika virus.

Journal Article Proc Natl Acad Sci U S A · February 28, 2017 Infection of pregnant women by Asian lineage strains of Zika virus (ZIKV) has been linked to brain abnormalities in their infants, yet it is uncertain when during pregnancy the human conceptus is most vulnerable to the virus. We have examined two models to ... Full text Link to item Cite

Immunologic challenges of human reproduction: an evolving story.

Journal Article Fertil Steril · September 1, 2016 Characterization of the implanting human fetus as an allograft prompted a field of research in reproductive immunology that continues to fascinate and perplex scientists. Paternal- or partner-derived alloantigens are present in the maternal host at multipl ... Full text Link to item Cite

Evidence for Differential Glycosylation of Trophoblast Cell Types.

Journal Article Mol Cell Proteomics · June 2016 Human placental villi are surfaced by the syncytiotrophoblast (STB), with a layer of cytotrophoblasts (CTB) positioned just beneath the STB. STB in normal term pregnancies is exposed to maternal immune cells in the placental intervillous space. Extravillou ... Full text Link to item Cite

Elevated concentration of secretory leukocyte protease inhibitor in the cervical mucus before delivery.

Journal Article Am J Obstet Gynecol · June 2016 BACKGROUND: Cervical remodeling during parturition progresses under exquisite regulation by immunologic mediators and proteases. Secretory leukocyte protease inhibitor is a secretory protein that can function as an antimicrobial peptide, an antiinflammator ... Full text Link to item Cite

Comparison of syncytiotrophoblast generated from human embryonic stem cells and from term placentas.

Journal Article Proc Natl Acad Sci U S A · May 10, 2016 Human embryonic stem cells (ESCs) readily commit to the trophoblast lineage after exposure to bone morphogenetic protein-4 (BMP-4) and two small compounds, an activin A signaling inhibitor and a FGF2 signaling inhibitor (BMP4/A83-01/PD173074; BAP treatment ... Full text Link to item Cite

Parallel Expression of Enzyme Inhibitors of CD8T Cell Activity in Tumor Microenvironments and Secretory Endometrium.

Journal Article Reprod Sci · March 2016 The divergent requirement for tolerance to support conception and protective response against sexually transmitted infections defines the unique immunological dynamics in the female reproductive tract (FRT). In part, these requirements are achieved by the ... Full text Link to item Cite

Effects of Lipopolysaccharide on Human First Trimester Villous Cytotrophoblast Cell Function In Vitro.

Journal Article Biol Reprod · February 2016 It has been shown that adverse obstetrical outcomes such as pre-eclampsia and intrauterine growth retardation correlate with maternal infection. In this study, we investigated mechanisms involved in infection-associated abnormalities in cytotrophoblast fun ... Full text Open Access Link to item Cite

Chlamydia trachomatis Infection of Endocervical Epithelial Cells Enhances Early HIV Transmission Events.

Journal Article PLoS One · 2016 Chlamydia trachomatis causes a predominantly asymptomatic, but generally inflammatory, genital infection that is associated with an increased risk for HIV acquisition. Endocervical epithelial cells provide the major niche for this obligate intracellular ba ... Full text Open Access Link to item Cite

Placental autotaxin expression is diminished in women with pre-eclampsia.

Journal Article J Obstet Gynaecol Res · September 2015 AIM: Lysophosphatidic acid (LPA) is a member of a new class of lipid mediators and exerts varied physiological and pathological functions. The secreted protein, autotaxin (ATX), is a key enzymatic determinant of local LPA production. The primary aim of thi ... Full text Link to item Cite

Isolation, purification and in vitro differentiation of cytotrophoblast cells from human term placenta.

Journal Article Reprod Biol Endocrinol · July 9, 2015 BACKGROUND: The syncytialization of cytotrophoblast cells to syncytiotrophoblast is central to human placental transport and hormone production. Many techniques for in vitro study of this process have been proposed and new investigators to the field may fi ... Full text Open Access Link to item Cite

Cervical Expression of Elafin and SLPI in Pregnancy and Their Association With Preterm Labor.

Journal Article Am J Reprod Immunol · June 2015 PROBLEM: Elafin and secretory leukocyte peptidase inhibitor (SLPI) are unique among antimicrobial peptides (AMPs). This study aimed to determine the expression levels of these AMPs at the cervix during pregnancy and to investigate their association with pr ... Full text Link to item Cite

Heightened potency of human pluripotent stem cell lines created by transient BMP4 exposure.

Journal Article Proc Natl Acad Sci U S A · May 5, 2015 Human pluripotent stem cells (PSCs) show epiblast-type pluripotency that is maintained with ACTIVIN/FGF2 signaling. Here, we report the acquisition of a unique stem cell phenotype by both human ES cells (hESCs) and induced pluripotent stem cells (iPSCs) in ... Full text Link to item Cite

Activation of decidual invariant natural killer T cells promotes lipopolysaccharide-induced preterm birth.

Journal Article Mol Hum Reprod · April 2015 Invariant natural killer T (iNKT) cells are crucial for host defense against a variety of microbial pathogens, but the underlying mechanisms of iNKT cells activation by microbes are not fully explained. In this study, we investigated the molecular mechanis ... Full text Link to item Cite

Genetic considerations in recurrent pregnancy loss.

Journal Article Cold Spring Harb Perspect Med · February 6, 2015 Human reproduction is remarkably inefficient; nearly 70% of human conceptions do not survive to live birth. Spontaneous fetal aneuploidy is the most common cause for spontaneous loss, particularly in the first trimester of pregnancy. Although losses owing ... Full text Link to item Cite

Modeling preeclampsia: An emerging role for stem cells

Journal Article NeoReviews · December 1, 2014 Preeclampsia is specific to human pregnancy and is cured by delivery of the gestation. The disease is particularly difficult to study because its underpinnings likely occur very early in pregnancy, but its detection is delayed until the second or third tri ... Full text Cite

Emerging roles for lysophospholipid mediators in pregnancy.

Journal Article Am J Reprod Immunol · August 2014 Recent progress in lipid research has unveiled new biologic roles for lysophospholipids as mediators of intercellular signaling. Lysophosphatidic acid (LPA) and sphingosine 1-phosphate (S1P) are representative lysophospholipids. Accumulating evidence sugge ... Full text Link to item Cite

Differentiation of trophoblast cells from human embryonic stem cells: to be or not to be?

Journal Article Reproduction · May 2014 It is imperative to unveil the full range of differentiated cell types into which human pluripotent stem cells (hPSCs) can develop. The need is twofold: it will delimit the therapeutic utility of these stem cells and is necessary to place their position ac ... Full text Link to item Cite

Immunology of pregnancy

Chapter · March 1, 2014 Alterations in local immune function occur during the course of a woman's menstrual cycle that result in changes in the quantity and distribution of immune cells within the female genital tract. As the uterus prepares for pregnancy and after conception occ ... Full text Cite

Overview

Chapter · January 1, 2014 The gonads are the end organs of reproduction, represented by the ovary in women and the testis in men (Fig. 1). They produce and release germ cells, central to the survival of the species. Ovaries contain all the oocytes they will ever have at birth, alth ... Full text Cite

Abnormal oxidative stress responses in fibroblasts from preeclampsia infants.

Journal Article PLoS One · 2014 BACKGROUND: Signs of severe oxidative stress are evident in term placentae of infants born to mothers with preeclampsia (PE), but it is unclear whether this is a cause or consequence of the disease. Here fibroblast lines were established from umbilical cor ... Full text Open Access Link to item Cite

Human decidual macrophages suppress IFN-γ production by T cells through costimulatory B7-H1:PD-1 signaling in early pregnancy.

Journal Article J Reprod Immunol · December 2013 In human pregnancy, CD14⁺ decidual macrophages (DMs) are the dominant professional antigen-presenting cells in the decidua, comprising 20-30% of the local leukocyte population. Although the relevance of DMs to feto-maternal immune tolerance has been descri ... Full text Link to item Cite

Manifestations of immune tolerance in the human female reproductive tract

Journal Article Frontiers in Immunology · September 16, 2013 Like other mucosal surfaces (e.g., the gastrointestinal tract, the respiratory tract), the human female reproductive tract acts as an initial barrier to foreign antigens. In this role, the epithelial surface and subepithelial immune cells must balance prot ... Full text Cite

Comparison of extravillous trophoblast cells derived from human embryonic stem cells and from first trimester human placentas.

Journal Article Placenta · July 2013 INTRODUCTION: Preeclampsia and other placental pathologies are characterized by a lack of spiral artery remodeling associated with insufficient invasion by extravillous trophoblast cells (EVT). Because trophoblast invasion occurs in early pregnancy when ac ... Full text Link to item Cite

Complete and unidirectional conversion of human embryonic stem cells to trophoblast by BMP4.

Journal Article Proc Natl Acad Sci U S A · March 26, 2013 Human ES cells (hESC) exposed to bone morphogenic protein 4 (BMP4) in the absence of FGF2 have become widely used for studying trophoblast development, but the soundness of this model has been challenged by others, who concluded that differentiation was pr ... Full text Link to item Cite

The prevalence of cervical regulatory T cells in HPV-related cervical intraepithelial neoplasia (CIN) correlates inversely with spontaneous regression of CIN.

Journal Article Am J Reprod Immunol · February 2013 PROBLEM: Local adaptive cervical regulatory T cells (Tregs) are the most likely direct suppressors of the immune eradication of cervical intraepithelial lesion (CIN). PD-1 expression on T cells induces Tregs. No studies have quantitatively analyzed the Tre ... Full text Link to item Cite

Immunology and Reproduction

Chapter · January 1, 2013 Full text Cite

A novel human endogenous retroviral protein inhibits cell-cell fusion.

Journal Article Sci Rep · 2013 While common in viral infections and neoplasia, spontaneous cell-cell fusion, or syncytialization, is quite restricted in healthy tissues. Such fusion is essential to human placental development, where interactions between trophoblast-specific human endoge ... Full text Open Access Link to item Cite

In reply

Journal Article Obstetrics and Gynecology · November 1, 2012 Full text Cite

Hyperosmolar glucose injection for the treatment of heterotopic ovarian pregnancy.

Journal Article Obstet Gynecol · August 2012 BACKGROUND: Heterotopic pregnancy describes the relatively rare coexistence of one or more intrauterine gestations and one or more extrauterine (ectopic) gestations. We describe a unique clinical case involving successful treatment of an ovarian heterotopi ... Full text Link to item Cite

Modulation of MICA on the surface of Chlamydia trachomatis-infected endocervical epithelial cells promotes NK cell-mediated killing.

Journal Article FEMS Immunol Med Microbiol · June 2012 Chlamydia trachomatis serovars D-K are obligate intracellular bacteria that have tropism for the columnar epithelial cells of the genital tract. Chlamydia trachomatis infection has been reported to induce modifications in immune cell ligand expression on e ... Full text Link to item Cite

Potential mechanisms for increased HIV-1 transmission across the endocervical epithelium during C. trachomatis infection.

Journal Article Curr HIV Res · April 2012 Among the now pandemic sexually transmitted infections (STIs), Chlamydia trachomatis (C. trachomatis) is the predominant bacterial pathogen and human immunodeficiency virus type 1 (HIV-1) is the most lethal of the viral pathogens. The female genital tract ... Full text Link to item Cite

Advances in antichlamydial antibody screening for tubal factor infertility

Journal Article Sexuality, Reproduction and Menopause · February 1, 2012 Cite

The role of intrauterine immune privilege in perinatal infectious diseases

Chapter · January 1, 2012 The pregnant uterus provides an immunologically "privileged" environment in which a genetically mismatched fetus typically thrives without deleterious allogeneic immune response. The mechanisms by which the fetus is protected from maternal immune attack ar ... Full text Cite

Preeclampsia: multiple approaches for a multifactorial disease.

Journal Article Dis Model Mech · January 2012 Preeclampsia is a pregnancy-specific disorder characterized by hypertension and excess protein excretion in the urine. It is an important cause of maternal and fetal morbidity and mortality worldwide. The disease is almost exclusive to humans and delivery ... Full text Link to item Cite

A possible coagulation-independent mechanism for pregnancy loss involving β(2) glycoprotein 1-dependent antiphospholipid antibodies and CD1d.

Journal Article Am J Reprod Immunol · January 2012 PROBLEM  β(2) glycoprotein1 (β(2) GP1)-dependent antiphospholipid antibodies (aPL) increase the risk for recurrent pregnancy loss. We address whether anti-β(2) GP1 antibodies can interact with phosphatidylserine (PS)-bearing CD1d on trophoblast cells and i ... Full text Link to item Cite

Innate immune mediator profiles and their regulation in a novel polarized immortalized epithelial cell model derived from human endocervix.

Journal Article J Reprod Immunol · December 2011 The endocervix in the female reproductive tract (FRT) is susceptible to sexually transmitted pathogens such as Chlamydia trachomatis and Neisseria gonorrhoeae. Endocervical epithelial cells in vivo make innate immune mediators that likely aid in the protec ... Full text Link to item Cite

Characterization of gut-derived intraepithelial lymphocyte (IEL) residing in human papillomavirus (HPV)-infected intraepithelial neoplastic lesions.

Journal Article Am J Reprod Immunol · November 2011 PROBLEM: Mucosal T cells are the most likely direct effectors in host anti-human papillomavirus adaptive immunity and regression of cervical intraepithelial neoplasia (CIN) lesions. There are no studies addressing intraepithelial lymphocytes (IELs) in CIN ... Full text Link to item Cite

Inhibition of indoleamine 2,3-dioxygenase activity by levo-1-methyl tryptophan blocks gamma interferon-induced Chlamydia trachomatis persistence in human epithelial cells.

Journal Article Infect Immun · November 2011 Gamma interferon (IFN-γ) induces expression of the tryptophan-catabolizing enzyme indoleamine 2,3-dioxygenase (IDO1) in human epithelial cells, the permissive cells for the obligate intracellular bacterium Chlamydia trachomatis. IDO1 depletes tryptophan by ... Full text Link to item Cite

Endocrinology and recurrent early pregnancy loss.

Journal Article Semin Reprod Med · November 2011 Endocrine disorders have been frequently linked to recurrent pregnancy loss (RPL). Because embryo attachment and early implantation are exquisitely controlled by the local hormonal milieu, endocrine-related pregnancy failures are likely to occur early in g ... Full text Link to item Cite

Does the classical M1/M2 dichotomy reflect the functional phenotypes of human decidual macrophages?

Journal Article Expert Review of Obstetrics and Gynecology · July 1, 2011 Constituents of the mononuclear phagocyte system, including macrophages (Ms), display a remarkable potential to acquire variable phenotypes that rely on cell-to-cell contact and exposure to soluble factors in the tissue microenvironment. Ms are a major sub ... Full text Cite

The regulation of T-cell cytokine production by ICOS-B7H2 interactions at the human fetomaternal interface.

Journal Article Immunol Cell Biol · March 2011 Although T cells are the most common decidual lymphocyte subset in late pregnancy, little is known about the mechanisms controlling their function. Costimulatory signaling, mediated by inducible costimulator (ICOS)-B7H2 interactions, is a known potent regu ... Full text Link to item Cite

Preeclampsia: animal models for a human cure.

Journal Article Proc Natl Acad Sci U S A · January 25, 2011 Full text Link to item Cite

Antichlamydial antibodies, human fertility, and pregnancy wastage.

Journal Article Infect Dis Obstet Gynecol · 2011 Genital infections with Chlamydia trachomatis (C. trachomatis) continue to be a worldwide epidemic. Immune response to chlamydia is important to both clearance of the disease and disease pathogenesis. Interindividual responses and current chlamydial contro ... Full text Open Access Link to item Cite

Chlamydia trachomatis immune evasion via downregulation of MHC class I surface expression involves direct and indirect mechanisms.

Journal Article Infect Dis Obstet Gynecol · 2011 Genital C. trachomatis infections typically last for many months in women. This has been attributed to several strategies by which C. trachomatis evades immune detection, including well-described methods by which C. trachomatis decreases the cell surface e ... Full text Open Access Link to item Cite

CD1d, a sentinel molecule bridging innate and adaptive immunity, is downregulated by the human papillomavirus (HPV) E5 protein: a possible mechanism for immune evasion by HPV.

Journal Article J Virol · November 2010 CD1d and CD1d-restricted natural killer T (NKT) cells serve as a natural bridge between innate and adaptive immune responses to microbes. CD1d downregulation is utilized by a variety of microbes to evade immune detection. We demonstrate here that CD1d is d ... Full text Link to item Cite

The contribution of macrophages to normal and pathological pregnancies.

Journal Article Am J Reprod Immunol · June 2010 Macrophages represent one of the major leukocyte subsets in the uterine decidua. Owing to their remarkable phenotypic plasticity, decidual macrophages can participate in diverse activities during pregnancy. At baseline, decidual macrophages are characteriz ... Full text Link to item Cite

The immunomodulatory roles of macrophages at the maternal-fetal interface.

Journal Article Reprod Sci · March 2010 Macrophages are versatile cells that play a central role in innate and adaptive immunity and participate in a wide variety of biological processes. In the uterine decidua, macrophages represent a major leukocyte subset throughout pregnancy. Here, decidual ... Full text Link to item Cite

Recurrent first trimester pregnancy loss: revised definitions and novel causes.

Journal Article Curr Opin Endocrinol Diabetes Obes · December 2009 PURPOSE OF REVIEW: First trimester pregnancy loss affects up to 15% of clinically recognized pregnancies. Whereas most couples will proceed to have successful subsequent pregnancies, 2-4% will suffer recurrent losses, often with no identifiable cause. In f ... Full text Link to item Cite

Review: human endogenous retroviruses and the placenta.

Journal Article Reprod Sci · November 2009 Up to 8% of the human genome is of retroviral origin. These stably integrated retroviral sequences that characterize the human endogenous retrovirus (HERV) arose from retroviral infections that occurred more than 25 million years ago. The host and the retr ... Full text Link to item Cite

Human decidual stromal cells suppress cytokine secretion by allogenic CD4+ T cells via PD-1 ligand interactions

Journal Article Human Reproduction · January 1, 2009 BACKGROUND: Although previous reports suggest an antigen-presenting function for decidual stromal cells (DSCs), the relevance of cell-to-cell communication between DSCs and T cells at the human feto-maternal interface has not been fully elucidated. Therefo ... Full text Cite

Prolactin can modulate CD4+ T-cell response through receptor-mediated alterations in the expression of T-bet.

Journal Article Immunol Cell Biol · October 2008 Low-dose prolactin induces proinflammatory responses and antibody production, whereas high-dose prolactin suppresses these responses. Mechanisms for these opposing effects remain incompletely defined. We have previously demonstrated that T-bet, a key trans ... Full text Link to item Cite

Expression of CD1d and ligand-induced cytokine production are tissue specific in mucosal epithelia of the human lower reproductive tract.

Journal Article Infect Immun · July 2008 Mucosal epithelia of the human lower reproductive tract (vagina, cervix, and penile urethra) are exposed to sexually transmitted microbes, including Chlamydia trachomatis. The in vivo susceptibility of each tissue type to infection with C. trachomatis is q ... Full text Link to item Cite

Expression of surface CD1d in the extravillous trophoblast cells of early gestational placenta is downregulated in a manner dependent on trophoblast differentiation.

Journal Article Biochem Biophys Res Commun · June 27, 2008 CD1d is a specific ligand for the invariant Valpha24Vbeta11-natural killer T (iNKT) cells that play an important role in placental development during early human pregnancy. The localization and regulation of placental CD1d expression remain unclear. Immuno ... Full text Link to item Cite

Cyclic regulation of T-Bet and GATA-3 in human endometrium.

Journal Article Reprod Sci · January 2008 Endometrial cytokine expression is poorly understood. T-Bet and GATA-3 regulate cytokine expression in T-lymphocytes. Previous work has demonstrated expression of T-Bet in human endometrium. Changes in human endometrial T-Bet and GATA-3 mRNA and protein ex ... Full text Link to item Cite

The fetal allograft revisited: does the study of an ancient invertebrate species shed light on the role of natural killer cells at the maternal-fetal interface?

Journal Article Clin Dev Immunol · 2008 Human pregnancy poses a fundamental immunological problem because the placenta and fetus are genetically different from the host mother. Classical transplantation theory has not provided a plausible solution to this problem. Study of naturally occurring al ... Full text Link to item Cite

Spontaneous adenomyosis in the chimpanzee (Pan troglodytes): a first report and review of the primate literature: case report.

Journal Article Hum Reprod · June 2007 Adenomyosis is a non-neoplastic condition characterized by the presence of ectopic endometrium in the myometrium with hyperplasia of adjacent smooth muscle. Common symptoms in women include debilitating pelvic pain and abnormal uterine bleeding, and the co ... Full text Link to item Cite

CD1d degradation in Chlamydia trachomatis-infected epithelial cells is the result of both cellular and chlamydial proteasomal activity.

Journal Article J Biol Chem · March 9, 2007 Chlamydia trachomatis is an obligate intracellular pathogen that can persist in the urogenital tract. Mechanisms by which C. trachomatis evades clearance by host innate immune responses are poorly described. CD1d is MHC-like, is expressed by epithelial cel ... Full text Link to item Cite

In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis.

Journal Article Altern Ther Health Med · 2007 OBJECTIVE: To provide an overview of the use of acupuncture as an adjunct therapy for in vitro fertilization (IVF), including an evidence-based evaluation of its efficacy and safety and an examination of possible mechanisms of action. DESIGN: Literature re ... Link to item Cite

Induction of maternal tolerance to fetal alloantigens by RANTES production.

Journal Article Am J Reprod Immunol · 2006 PROBLEM: Previous studies have demonstrated a requirement for RANTES (regulated on activated normal T-cell expressed, and secreted) at immune privileged sites; we have investigated the role of RANTES in the induction of maternal-fetal tolerance. METHOD OF ... Full text Link to item Cite

Cyclic regulation of epithelial T-Bet expression in human endometrium

Conference JOURNAL OF THE SOCIETY FOR GYNECOLOGIC INVESTIGATION · 2006 Cite

Female steroid hormones use signal transducers and activators of transcription protein-mediated pathways to modulate the expression of T-bet in epithelial cells: a mechanism for local immune regulation in the human reproductive tract.

Journal Article Mol Endocrinol · August 2005 The transcription factor T-bet promotes the differentiation of inflammatory Th1 T helper cells. T-bet expression in lymphoid cells is regulated by cytoplasmic signaling through Janus kinase phosphorylation, nuclear signaling using signal transducers and ac ... Full text Link to item Cite

T-helper 2 and 3 type immunity to trophoblast in successful in vitro fertilization-embryo transfer.

Journal Article Fertil Steril · June 2005 OBJECTIVE: To determine whether peripheral blood mononuclear cell (PBMC) secretion of T-helper (Th)-1 type cytokines and Th-2 and Th-3 type cytokines in women undergoing in vitro fertilization-embryo transfer (IVF-ET) is associated with therapeutic failure ... Full text Link to item Cite

Immune interactions at the maternal-fetal interface: a focus on antigen presentation.

Journal Article Am J Reprod Immunol · April 2004 PROBLEMS: Viruses and fetuses face similar immunologic challenges. Each must evade immune detection and destruction. The virus must avoid host recognition of intracellular infection; the fetus allogenic recognition. Each has manipulated the process of anti ... Full text Link to item Cite

Comparison of ophthalmic sponges for measurements of immune markers from cervical secretions.

Journal Article Clin Diagn Lab Immunol · March 2004 Measurements of cervical immunity are important for evaluating immune responses to infections of the cervix and to vaccines for preventing those infections. Three ophthalmic sponges, Weck-Cel, Ultracell, and Merocel, were loaded in vitro with interleukin-1 ... Full text Link to item Cite

Expression of membrane-bound HLA-G at the maternal-fetal interface is not associated with pregnancy maintenance among patients with idiopathic recurrent pregnancy loss.

Journal Article Mol Hum Reprod · September 2003 Recurrent pregnancy loss (RPL) has many known aetiologies. However, using current diagnostic testing, a large fraction of recurrent pregnancy losses remain unexplained. Many of these may have immune underpinnings. HLA-G is a non-classical MHC class I produ ... Full text Link to item Cite

Gene expression profiling reveals progesterone-mediated cell cycle and immunoregulatory roles of Hoxa-10 in the preimplantation uterus.

Journal Article Mol Endocrinol · April 2003 Human infertility and recurrent pregnancy loss caused by implantation defects are poorly understood. Hoxa-10-deficient female mice have severe infertility and recurrent pregnancy loss due to defective uterine implantation. Gene expression profiling experim ... Full text Link to item Cite

Implantation and the survival of early pregnancy.

Journal Article N Engl J Med · November 8, 2001 Full text Link to item Cite

Human cytomegalovirus US2 endoplasmic reticulum-lumenal domain dictates association with major histocompatibility complex class I in a locus-specific manner.

Journal Article J Virol · June 2001 The human cytomegalovirus-encoded US2 glycoprotein targets endoplasmic reticulum-resident major histocompatibility complex (MHC) class I heavy chains for rapid degradation by the proteasome. We demonstrate that the endoplasmic reticulum-lumenal domain of U ... Full text Link to item Cite

Erratum: The journal of experimental medicine (November 20, 2000) 192:10 (1521-1527)

Journal Article Journal of Experimental Medicine · February 5, 2001 Full text Cite

Murine female reproductive tract intraepithelial lymphocytes display selection characteristics distinct from both peripheral and other mucosal T cells.

Journal Article J Reprod Immunol · 2001 Despite immense effort, the development of vaccines effective at mucosal sites has proceeded at a faltering pace. Efforts concentrating on humoral immunity but neglecting cellular immunity may be misdirected by ignoring many viral mucosal pathogens. Improv ... Full text Link to item Cite

Trophoblast function and dysfunction during early implantation and placentation

Journal Article Infertility and Reproductive Medicine Clinics of North America · January 1, 2001 Normal human placentation depends on a process that is very similar to tumor invasion. Specialized placental cells, termed trophoblasts, breach the uterine epithelium, after which they invade the uterine wall and the associated portions of maternal blood v ... Cite

Qa-2-dependent selection of CD8alpha/alpha T cell receptor alpha/beta(+) cells in murine intestinal intraepithelial lymphocytes.

Journal Article J Exp Med · November 20, 2000 Murine intestinal intraepithelial lymphocytes (iIELs) are made up of a heterogeneous mix of T cells with unique phenotypes. Whereas CD8(+) T cells in peripheral lymphoid organs use CD8alpha/beta and are selected on MHC class Ia molecules, a majority of iIE ... Full text Link to item Cite

Can viruses help us to understand and classify the MHC class I molecules at the maternal-fetal interface?

Conference Hum Immunol · November 2000 Placental expression of HLA-C, HLA-E, and HLA-G locus products is now well described. However, to date, the functional relevance of these MHC class I products at the maternal-fetal interface is incompletely described. We propose here that HLA-C, -E, and -G ... Full text Link to item Cite

HLA-G, -E, -F preworkshop: tools and protocols for analysis of non-classical class I genes transcription and protein expression.

Conference Hum Immunol · November 2000 Non-classical MHC class I HLA-E, -F, and -G molecules differ from classical class I histocompatibility antigens by specific patterns of transcription, protein expression, and immunological functions. Restriction of the expression pattern of these non-class ... Full text Link to item Cite

Viral subversion of the immune system.

Book · 2000 This review describes the diverse array of pathways and molecular targets that are used by viruses to elude immune detection and destruction. These include targeting of pathways for major histocompatibility complex-restricted antigen presentation, apoptosi ... Full text Link to item Cite

HLA-G and HLA-C at the feto-maternal interface: lessons learned from pathogenic viruses.

Journal Article Semin Cancer Biol · February 1999 Immunoevasive viruses which effect antigen presentation by class I major histocompatibility complex (MHC) molecules have helped to broaden our understanding of the intracellular transport and processing of HLA-G and HLA-C in the placenta. Cellular infectio ... Full text Link to item Cite

Trophoblast class I major histocompatibility complex (MHC) products are resistant to rapid degradation imposed by the human cytomegalovirus (HCMV) gene products US2 and US11.

Journal Article J Exp Med · August 3, 1998 US11 and US2 encode gene products expressed early in the replicative cycle of human cytomegalovirus (HCMV), which cause dislocation of human and murine major histocompatibility complex (MHC) class I molecules from the lumen of the endoplasmic reticulum to ... Full text Link to item Cite

Why certain antibodies cross-react with HLA-A and HLA-G: epitope mapping of two common MHC class I reagents.

Journal Article Mol Immunol · February 1998 Antigen presentation at the maternal-fetal interface has been characterized by a reported lack of classical MHC class I products and the presence of a tissue-restricted, non-classical class I product with limited polymorphism, HLA-G. The lack of HLA-A, -B, ... Full text Link to item Cite

Progesterone-induced immunosuppression.

Journal Article Hum Reprod · June 1997 Link to item Cite

Herpes simplex virus blocks intracellular transport of HLA-G in placentally derived human cells.

Journal Article J Immunol · October 15, 1996 Spontaneous fetal loss is associated with herpes simplex virus (HSV) infection as deduced from epidemiologic data. To date, the underlying mechanisms remain to be elucidated, but an immune component is suspected. HLA-G is a class I MHC molecule selectively ... Link to item Cite

Progesterone-induced immunosuppression is not mediated through the progesterone receptor.

Journal Article Hum Reprod · May 1996 Progesterone is a known immunosupressant in humans and may be important in treatment regimens for women with immunological and endocrinological reproductive failure. The molecular mechanism of progesterone-mediated immunosuppression remains controversial. ... Full text Link to item Cite

Correlation of serum cytokine and adhesion molecule determinations with pregnancy outcome.

Journal Article J Soc Gynecol Investig · 1996 OBJECTIVE: To test the hypothesis that serum levels of T helper [Th]-1-type (interleukin [IL]-2, interferon [IFN]-gamma, tumor necrosis factor [TNF]-alpha) and Th2-type (IL-10) cytokines and the soluble intracellular adhesion molecule-1 (sICAM-1) are assoc ... Full text Link to item Cite

Treatment of uterine leiomyomas in the perimenopause

Journal Article Infertility and Reproductive Medicine Clinics of North America · September 20, 1995 Treatment options for the perimenopausal woman with symptomatic uterine fibroids include expectant management, medical therapy, and surgical intervention. Expectant management with close clinical follow-up evaluation is the treatment of choice for either t ... Cite

Primary adenocarcinoma of the gallbladder presenting as primary gynecologic malignancy: a report of two cases.

Journal Article Obstet Gynecol · May 1994 BACKGROUND: Carcinoma metastatic to the uterus from extragenital sites is rare. Such metastatic disease is typically diagnosed at autopsy or in patients with known primary malignancies. This report discusses two cases of primary carcinoma of the gallbladde ... Link to item Cite

Leiomyomas of the fallopian tube. A case report.

Journal Article J Reprod Med · September 1993 Both heterotopic pregnancies and primary neoplasms of the fallopian tube are rare occurrences. A patient presented with early pregnancy, abdominal pain and ultrasound findings of an intrauterine gestation and a fallopian tube mass. Laparotomy revealed a pr ... Link to item Cite