Takashi Koyanagi's research while affiliated with Kyushu University and other places
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Publications (75)
In order to reveal whether or not rhythmic changes exist in fetal stomach movement (FSM), in utero FSM was assessed in three fetuses between 27 and 33 weeks' gestation with congenital duodenal obstruction. A total of four observations, one each at 27, 29, 31 and 33 weeks' gestation, was obtained. The longitudinal transection of each fetal stomach w...
We describe herein a 32-year old Japanese women, with primipara of pregnancy complicated with refractory anemia type of myelodysplastic syndrome (MDS), inevitably requiring repeated HLA-type compatible platelet transfusion as treatment for frequent nasal bleeding and purpura occurring in the third trimester of gestation, with successful outcome in...
To clarify whether twin fetuses could be clustered quantitatively observing in utero cardiovascular system function, 71 twin-paired fetuses between 24 and 40 weeks' gestation were subjected. Cluster analysis was performed using four variables; end-diastolic dimension and fractional shortening in the right ventricle (EDD, FS), resistance index in th...
Objective: Our purpose was to characterize neutrophil degranulation activity related to the manifestation of preeclampsia.
Materials and Methods: Studied were nine nonpregnant healthy women, nine normal pregnant women, and six cases with preeclampsia in the third trimester. Neutrophil preparations obtained for each case were divided into one nonsti...
To quantitatively determine the extent to which a given heart rate correlates with the following heart rate(s) at any gestational age, we studied 181 uncomplicated human fetuses between 23 and 41 weeks gestation. A continuous 90-120 min observation was made for each case using external Doppler-ultrasound cardiotocography. For every individual fetal...
We experienced 12 cases of congenital cystic adenomatoid malformation of the lung (CCAM) including 6 cases diagnosed antenatally. They were classified into three groups according to the clinical manifestations. Group A was associated with hydrops fetalis (n = 3), group B presented with respiratory distress symptoms after birth (n = 6), and group C...
The authors report a female case of prune-belly syndrome having an antenatal sonographic diagnosis of hydrops fetalis and treated prenatally with transplacental digitalis administration. The findings of this case suggest that the clinical entity includes various phenotypes or aberrants having different origins.
An infant girl with extralobar pulmonary sequestration (PS) composed of congenital cystic adenomatoid malformation (CCAM)-like structure is presented. Initially, the antenatal sonographic findings indicated CCAM. The macroscopic findings of the resected specimen were compatible with extralobar PS; however, the microscopic findings showed cystic str...
To determine the biologic significance of a transient anechoic area observed in the midline of the fetal neck when attempting an antenatal ultrasound diagnosis of congenital esophageal atresia (CEA), a prospective study was made in 10 cases presenting both polyhydramnios and an unusually small stomach size due to a decrease in fetal stomach fluid....
c1 Takashi Koyanagi, Associate professor, Department of Gynecology and Obstetrics, Faculty of Medicine, Kyushu University, 60 Maidashi 3-1-1, Higashiku, Fukuoka 812, Japan.
The aim of this study is to reveal whether the penis per se actually becomes tumescent and flaccid, in time sequence, in the human fetus at term. We observed the fetal penis with real-time ultrasonography in 50 male human fetuses at 36-39 weeks' gestation and measured the penile length once at a given time per 1-min epoch for each case during the 6...
To quantitatively characterize the stereographic stomach configuration in utero, 11 fetuses (subject-group) with congenital duodenal obstruction, diagnosed antenatally, between 29 and 37 weeks' gestation were studied. Also included were 879 uncomplicated fetuses between 20 and 40 weeks' gestation as a control-group. Applying the algorithm which we...
Our purpose was to characterize eye movement patterns in the human fetus at term persisting in breech presentation.
Studied were 11 fetuses in breech presentation and 12 in cephalic presentation at 36 to 41 weeks' gestation, of which the presentation remained unchanged from 32 weeks' gestation until delivery. With real-time ultrasonography we analy...
We studied superoxide (O2-) production in neutrophils from 78 normal pregnant women at 7 to 39 weeks' gestation to determine whether there is a critical gestational age in O2- production activity of maternal neutrophils. The O2- production was measured by determining the rate of superoxide dismutase-inhibitable reduction of ferricytochrome c at 550...
To reveal which fetal life-threatening diseases significantly contribute to impairment of in-utero urine production and also to determine the gestational age at which time aberrant urine production becomes manifest, we observed 376 compromised fetuses (subject group) at 21–42 weeks' gestation using ultrasonography. A total of 358 uncomplicated fetu...
Our objective was to determine the minimum number of fetal heart rates (FHRs) needed to assess various fetal conditions adequately, focusing on FHR changes in relation to gestational age. We used probability distribution matrices previously derived from 10,934,604 FHRs of 743 uncomplicated fetuses. These matrices were made at nine consecutive 2-wee...
Analysis of FHR variability attempts to be able to distinguish which FHR changes are physiological and which are pathological. From the results of such studies, it is hoped that clinicians will be provided with the means to identify accurately which fetuses are healthy, which are at risk and which are actually in distress at any gestational age. Th...
To reveal the developmental characteristics of the fetal stomach in utero, this study was made on 879 subjects from 20 to 40 weeks' gestation. By applying the system of 'Modeling a three-dimensional shape from a silhouette by detecting symmetry' which we devised, we reconstructed the three-dimensional shape, from the outline of the longitudinally t...
To clarify the pathophysiological changes of pre-eclampsia, we investigated the injurious effect of sera from women with pre-eclampsia on cultured endothelial cells, vascular smooth muscle cells and fibroblasts. We obtained serum samples from 32 Japanese women, including 10 healthy nonpregnant women, 12 normal pregnant women and 10 women with pre-e...
We devised a new method using a probability distribution matrix to simultaneously describe variation in the characteristics of fetal heart rate (FHR) and beat-to-beat difference (DFHR) between the present and the immediately following FHR. The FHRs were plotted in columns, DFHRs in rows and probabilities in the corresponding elements of the matrix....
We attempted to identify the brain segment which controls heart rate changes in human fetuses with advancing gestation. Twelve anencephalic and 165 normal fetuses (control-group fetuses) between 25-32 weeks' gestation were studied. The instantaneous fetal heart rate (FHR) data were obtained from each fetus for a continuous 90-120 min period, using...
This is the first case report on the diagnosis of spinal cord injury due to hemorrhage during the neonatal period using magnetic resonance imaging (MRI). Somatosensory evoked potentials are also helpful in the functional demonstration of this lesion. When discrepant signs, alert consciousness and intact cranial nerves are observed in newborn babies...
We herein reviewed 630 malformed fetuses delivered from 24 weeks of gestation onwards in our institute over the past 22 years. These fetuses were divided into 2 groups: 210 from 1970 to 1982 (group 1) and 420 from 1983 to 1991 (group 2). Twenty-two varieties of congenital malformations were diagnosed antenatally in group 1, whereas 55 additional ma...
Since 1981, when eye movements of the human fetus were first reported, the study of fetal eye movements has increased, mainly focusing on the ontogenesis of eye movements and as one parameter of behavioral states. Using real-time ultrasound, fetal eye movements can be clearly observed from 14 weeks of gestational age. Fetal eye movements may be des...
Fetal behavioural patterns were examined to test whether they could be used to localise sites of brain damage antenatally. Decreased fetal movement, persistent nonreactive fetal heart rate (FHR) pattern, and/or central nervous system malformation were used as indicators of possible neurological impairment. Ten fetuses tested in this way underwent f...
To evaluate the ontogenesis of ultradian rhythm of alternating eye movement (EM) and no eye movement (NEM) period durations, a cross-sectional study was conducted on 240 human fetuses from 25 to 41 weeks of gestation, using real-time ultrasound to observe eye movements. Two critical points for the duration of the EM period were found at 29-30 and 3...
To determine whether preeclampsia enhances superoxide generation of neutrophils.
Samples were obtained from 12 normal nonpregnant, 15 normal pregnant, and 11 preeclamptic women. The superoxide production of neutrophils was measured by the superoxide dismutase-inhibitable reduction of ferricytochrome C at 550-540 nm using a dual-wavelength spectroph...
The aim of this study was to measure the fetal lung area of normal human fetuses using ultrasound and them to test the predictive values of a nomogram in the identification of fetal lung hypoplasia. A nomogram for ultrasound-measured fetal lung area were constructed from 264 normal fetuses from 17 to 39 weeks of gestation. In 19 cases running the r...
We describe three fetuses at term that demonstrated abnormal behavioral patterns in utero when observed using real-time ultrasound. The abnormal patterns turned out to have neurologic correlations after birth. In case 1, despite a normal breathing pattern, no movement in any of the four extremities was observed, thus suggesting the existence of a s...
The aim of our study was to reveal whether pupils dilate and constrict in a time sequence in the human fetus and to assess the relationship between changes in pupillary diameter and eye-movement-no-eye-movement periods.
We simultaneously observed pupil and eye movement with real-time ultrasonography in 30 human fetuses at 36 to 41 weeks' gestation....
The objective of this study was to investigate whether micturition occurs, temporally related to the onset of the rapid eye movement (REM) period, in the human fetus. The study was made on 139 fetuses at 33–36 weeks and 153 at 37–41 weeks gestation. The discrepancies between the expected (Fexp) and observed (Fobs) frequencies of time lag between th...
To clarify the role of endothelial cells in pregnancy-related hypertensive disorders, we studied the cytotoxic effect of sera from normal pregnant women and from gravidas with various hypertensive complications of pregnancy.
We obtained serum samples from 84 Japanese women: 17 with preeclampsia, ten with gestational hypertension, six with chronic h...
The changes of whole blood viscosity and plasma viscosity were studied in 15 normal non-pregnant women, and 120 normal pregnant women ranging from 8 to 39 weeks of gestation. The values of whole blood viscosity during normal pregnancy were significantly lower from 20 to 31 weeks of gestation than those in the other periods of gestation, and there w...
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We report herein a case of fetal complete atrioventricular block accompanied with endocardial cushion defect, successfully diagnosed and treated, in utero, with transplacental digitalization. A 23-year-old Japanese woman, at 20 weeks of gestation, was referred to the Maternity and Perinatal Care Unit of Kyushu University Hospital because of fetal c...
In 51 cases with non-immunologic hydrops fetalis (NIHF), perinatal management was performed based on our protocol. Twenty-two cases were treated by albumin and/or packed red cell (PRC) injection into the fetal abdominal cavity, and 9 cases by transplacental digitalization. Among the cases treated by albumin and/or PRC injection, 6 of 8 cases withou...
In order to reveal whether or not brain impairment occurs in the human fetus during the intrauterine period, we described three term fetuses, having successful prenatal diagnosis of localized brain lesion, through the real-time ultrasound observation of in utero behavioral patterns. Movement of extremities, breathing movement, alternation of REM (r...
A case of May-Hegglin anomaly, a rare autosomal dominant thrombocytopenia, is reported. This disorder is characterized by giant platelets, basophilic inclusion bodies within the cytoplasm of granulocytes and an occasional bleeding tendency. This bleeding tendency depends on the platelet count. The fetuses of such patients run the risk of intracrani...
A comparison has been made between 16 infants with omphalocele treated between 1962 and 1975 (group A) and 22 treated between 1976 and 1989. In the latter group 11 antenatally detected cases (group C) were considered separately from the 11 cases diagnosed at birth (group B). Recent advances have reduced the mortality for neonates with omphalocele f...
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Moebius syndrome (MS) is described in an infant with central hypoventilation and brainstem calcification. The patient had limb defects and bilateral paralysis of the 6th, 7th, 9th, 10th, and 12th cranial nerves. Mechanical ventilation was continued from birth because of shallow spontaneous respiration. Computed tomography revealed brainstem atrophy...
To assess how REM/NREM periods can be linked to the determination of the REM/NREM sleep and/or awake state, we have investigated the relationship between the REM/NREM periods and penile tumescence in the human fetus. This study was made on 11 male fetuses from 36 to 41 weeks of gestation. Eye movement and penile tumescence were simultaneously exami...
Between 1980 and 1987, we investigated the outcome for 20 infants with birth weights less than 750 g, admitted to the neonatal unit of Kyushu University Hospital. All infants were delivered at the hospital. Seven infants (35%) survived and were discharged. Comparing the first and second 4 year periods, the survival rate improved from 17% (1 of 6 in...
The goal of this study was to determine whether rapid eye movement and slow eye movement exist during the eye-movement period in the human fetus in utero. We studied 21 fetuses with real-time ultrasonography, 10 from 33 to 36 weeks and 11 from 37 to 41 weeks' gestation. We used the duration of eye-movement unit as a parameter and calculated the cum...
To evaluate the relationship between heart rate and rhythm, and cardiac performance, in the human fetus in utero, observed over a long-term period in gestation, we made a total of 138 studies in 114 fetuses from 18 to 41 weeks of gestation; 104 having heart rate changes without rhythm disturbances ("control group"), 6 with complete atrioventricular...
To elucidate processes involved in the developing fetal stomach in utero, we examined chronological changes in maximum longitudinal and anteroposterior gastric dimensions in 618 fetuses from 16 to 41 weeks of gestation, using real-time ultrasound. Three statistically critical points were evident at 26–27, 32–33, and 36–37 weeks of gestation. Both d...
In the present study, we attempted to assess the safety and the risk of cordocentesis under ultrasound guidance for fetal blood sampling. Forty-five cordocenteses in 43 cases were carried out. These forty-three cases included 23 nonimmunologic hydrops fetalis, 12 congenital fetal malformations, 3 chromosome aberrations, 3 Rh isoimmunization, and 2...
Based on a 2-year experience using a perinatal information system and a microcomputer-based local area network (LAN), we assessed the LAN system to see how it provided positive feedback in daily perinatal practice. Discussed herein are the results pertaining to the compatibility between data on conventional patient's charts and that input into the...
To assess how different cardiotocographic (CTG) findings are related to changes in vascular resistance, 256 normal and 37 growth retarded (IUGR) fetuses from 27 to 41 weeks of gestation were studied.Immediately following CTG monitoring, pulsed Doppler was used to identify flow velocity waveforms in both the middle cerebral artery (MCA) and the umbi...
This appears to be the first documentation of an accurate antenatal diagnosis of pulmonary arteriovenous fistula complicated with hydrops fetalis. The combined use of real-time Doppler color flow imaging with the real-time ultrasound proved to be useful for imaging the complex hemodynamics of vascular connection while simultaneously evaluating the...
To evaluate whether mouthing movement in the human fetus is related to advance in gestational age and whether such movement is concurrent with rapid eye movement or non-rapid eye movement phases, 26 fetuses from 28 to 41 weeks' gestation were observed for 60 continuous minutes with real-time ultrasonography. It was evident that regular mouthing mov...
To evaluate the outcome of fetal arrhythmias, serial echocardiographic examinations were made on 29 fetuses between 18 and 41 weeks gestation, including 23 with premature contractions (PCs) and 6 with complete atrioventricular block (AVB). Of the cases of PCs 43.5% (10/23) disappeared spontaneously during the antenatal period. 39.1% (9/23) converte...
We devised a method using a matrix to condense the large scale of fetal heart rates (FHR) without altering their characteristics. This matrix was arranged by FHRs at one beat per minute (bpm) intervals in rows, beat-to-beat differences (DFHRs) at one bpm intervals in columns and probabilities in the corresponding elements, respectively. Three matri...
To evaluate the physiological profile of human cerebral circulation, chronological sequences of flow velocity waveforms in the middle cerebral artery were studied using a pulsed Doppler method. Included were a total of 92 normal fetuses between 27 and 41 weeks of gestation, among which waveforms could be recorded in 81 cases (88.0%). Raw data of th...
Seven fetuses with idiopathic hydrops fetalis (IHF) were treated in utero by injecting albumin into the fetal abdominal cavity and by removal of accumulated fluid from the serous cavities. Signs of hydrops fetalis disappeared in utero in one, and skin edema significantly decreased in another. In the other five, signs of hydrops fetalis remained unc...
In order to control perinatal medical information, we developed a microcomputer-based local area network. This system has been in practical operation since June, 1986. We have assessed this system with regard to both patient-machine and doctor-machine interfaces. Consequently, although input operation took 20-30% longer per individual patient than...
To investigate the process of homeothermal acclimation to extrauterine environment, core and peripheral body temperatures in the human neonate were continuously and simultaneously recorded. Twenty-one term-delivered babies were divided into two groups. In group I, 10 babies were kept at 32-34 degrees C for the first 2 h of extrauterine life and at...
To quantitatively predict the progress of labor, we devised a mathematical model suitable for the Markov process. Included were 625 primiparas who went into spontaneous labor between 37 and 41 weeks of gestation with a cephalic presentation. When applying the Markov process, the sequence of labor was divided into eight categories from 4 cm cervical...
We devised a model suitable for mathematical analysis of beat-to-beat differences (BBDs) in fetal heart rates (FHRs). Factor analysis was applied, using a computer system, on a specially devised model of an FHR matrix. This matrix was arranged with FHRs and BBDs at 1-beat/min intervals by rows and columns, respectively. After obtaining the BBD by s...
To evaluate the physiological profile of fetal urine production with advance in gesta-tional age, we observed the volume of urine retained in the bladder, using real-time ultrasound. Here, the parameters of maximum urine volume, periodicity of urination and the urine production rate were analyzed. Urine volume can be measured by 3 orthogonal diamet...
We present an outline of our microcomputer-based Local Area Network (LAN) system designed to process information related to perinatal events. This system enables any of the medical personnel to use a microcomputer terminal installed at the bedside and also to process, in a real-time manner, new input-information together with past information, ther...
This echocardiographic study was designed to determine the accuracy of prenatal diagnoses of fetuses with cardiac anomalies and also to evaluate the manner in which various types of disorders affect the prognoses in utero. In 13 fetuses studied, the following cardiac anomalies were present: ventricular septal defect (VSD), atrial septal defect (ASD...
Functional development of eye movement in the human fetus in utero was assessed quantitatively, with real-time ultrasound. A pair of lens-derived echoes was used as a landmark to evaluate positional deviation with eye movement. The frequency of eye movement was measured either with 1-minute continuous observations or at 1-minute cross sections. Two...
Four fetuses with nonimmunologic hydrops fetalis were treated in utero. The initial diagnosis was made between 27 and 32 weeks of gestation. All fetuses had generalized edema and pleural effusion at the time of diagnosis. In order to maintain plasma colloid osmotic pressure in the fetus, fetal transfusion of albumin was carried out. Because pleural...
In four fetuses with gastroduodenal obstructions, different types of lesions were diagnosed prenatally by real-time ultrasonic tomography. Surgery in the early neonatal period confirmed these findings. The sites of obstruction corresponded to the anatomical configuration of the gastroduodenal area.
Diagnostic criteria to identify individual lesions...
In utero real-time ultrasonic tomography revealed malattachment of the tricuspid valve in two cases at 33 weeks of gestation. Enlargement of the right ventricle and atrium and a decrease in thickness of the right ventricular wall were also observed in one fetus while a small ventricle and enlargement of the right atrium were seen in the second fetu...
On the basis of echographic characteristics, there were 3 different layers involved in the normal uterus. The innermost layer was considered to represent the endometrium, which varied its thickness gradually and offered the massive echogenic area in the late secretory phase. Since such alterations in the tissues were seen in every case of the longi...
The incidence of fetal malformation was reviewed and an assessment made of the diagnostics of ultrasound. The prognosis of the related cases, as related to the clinical application of ultrasound was discussed.
Forty-seven of 56 malformed fetuses were correctly diagnosed antenatally (84%). Diagnostic accuracy in the case of real-time B scan was 91%,...
To investigate the relevancy of birth weight, data on 300 term newborn infants were subjected to a reevaluation of 31 variables related to body measurements of both the mother and child and to the placenta. Factor analysis was introduced to analyze the data obtained. Each group was composed of multiple factor axes, of which factor structures were r...
Since the narcotic receptors have been recognized to localize in the central nervous system, a kind of new analgesic method has been attempted to be established in the field of pain control. Excellent results were so far obtained by injecting morphine chloride into epidural spaces (Epidural Morphine) in animal experiments as well as in human trials...
Citations
... Although many fetopathies associated with NIHF have been reported, the etiology and the underlying disorders cannot be determined in approximately 30 percent [14]. In these cases of idiopathic hydrops fetalis (IHF), a characteristic and common finding is hypoproteinemia [11] . The decreased serum protein concentration may play an important role in establishing the clinical picture of hydrops fetalis. ...
... However, the role of β-glucuronidase in the context of bovine pregnancy has been poorly elucidated and very limited literatures are available depicting its significant role during pregnancy. Amagase et al. (1997) reported no significant difference in the βglucuronidase activity in the neutrophils of the non-pregnant and the normal pregnant women. ...
... REM sleep develops during the fetal period and is observed from about 30 weeks of gestation [2][3][4][5] . REM sleep occupies a large proportion of sleep in full-term neonates, but this gradually decreases with REM activity 5,16 . ...
... To account for interindividual variability, a sample of 800 fetuses was generated and data at six gestational ages (15,20,25,30,35, and 40 weeks) were summarized for the changes in the parameter values using constant coefficient of variations (CV), based on the observed data, of 30% for FUPR, 25% for UrCr, and 25% for SerCr. Due to the absence of fetal GFR measurements, data from preterm and term neonates observed immediately after birth were compared against the predicted fetal GFR using Equation 4. ...
... If the omphalocele is an isolated lesion, the prognosis for survival after postnatal surgical correction reaches 90%. However, the presence of several other abnormalities or malformations that cannot be treated is associated with a poor overall prognosis (12). Many studies have suggested an increase in morbidity associated with the presence of multiple anomalies, genetic problems, liver position and others issues (13). ...
... FGR fetuses (n = 23) were also retrospectively analyzed at both Osaka Metropolitan University Hospital and Osaka City General Hospital from April 2011 to November 2021. FGR was defined as an estimated fetal weight (EFW) < −2.0 SD of the local reference range and with an elevated umbilical artery PI > 95th percentile of the reference range [11]. Gestational age (GA) was calculated from the last menstrual period and confirmed by the crown-rump length measured between the 9th and the 11th gestational week. ...
... It has been assumed that there is a relationship between the onset of REM sleep (eye movement period) and micturition during 37-41 weeks of gestation, but not at 33-36 weeks. [10] This suggests a neuronal development of descending control of fetal micturition whereby the close relationship between the locus coeruleus and peri alpha (REM sleep) and the control center of micturition (the dorsolateral tegementum, pons) becomes obvious in the human Ba term^fetus [18]. The finding that bladder voiding in infants is accompanied with a change in heart rate, which is associated with internal stimuli, stipulates the hypotheses that a change in heart rate is affiliated with cortical arousal [38]. ...
... [83][84][85] This change in geometry could be a physiologic response to increasing hydrostatic pressure and urine output with development. 51,86 COL4 and HSPG2 are necessary for basement membrane integrity, because mutations can lead to tubular basement membrane splitting and cysts, glomerulocystic disease, and altered functioning of the glomerular basement membrane. [87][88][89] Proteins known to promote glomerular filtration unit stability and maturation, 90-94 COL4A3-5, LAMA3, LAMA5, and LAMB2, were significantly elevated or exclusive to the adult ( Figures 3 and 4C). ...
... Our study also lacks in correlating the size of the fetal stomach with the weight of the fetuses, as the fetuses were from pregnancies with a bad fetal outcome. The stomach's capacity is increased due to the growth of the left gastric wall [27]. The growth of omental bursa into the compound mesodermal analgen of the primitive right gastric wall and gastric mesenteries leads to the growth of the left gastric wall. ...
... However, cases of successful vaginal deliveries without complications have been reported. 66,67 ...
Reference: Inherited giant platelet disorders
