Kyushu University Academic Staff Educational and Research Activities Database
List of Reports
Kiyoko Kato Last modified date:2022.06.16

Professor / Reproductive and Developmental Medicine / Department of Clinical Medicine / Faculty of Medical Sciences


Reports
1. Tada Y, Yasunaga M, Tomonobe H, Yamada Y, Hori E, Okugawa K, Yahata H, Oda Y, Kato K, A Case of Malignant Phyllodes Tumor of the Breast Metastasizing to the Ovary. Int J Surg Pathol, Int J Surg Pathol. Online ahead of print, 10.1177/10668969211056912, 2021.11, Phyllodes tumors of the breast are uncommon, and 6.2% of phyllodes tumors behave in a malignant fashion. The metastatic spread of malignant phyllodes tumor is mainly hematogenous to lung and bone, and malignant phyllodes tumor metastasizing to the ovary is rare, with only 2 cases reported. We report the third case of metastatic malignant phyllodes tumor to the ovary with a focus on the differential diagnosis of ovarian cancer.
Keywords: malignant phyllodes tumor of the breast; metastasis; ovary..
2. Nakahara K, Morokuma S, Kato K, Recent Topics in Fetal Behavioral Assessment, Donald School Journal of Ultrasound in Obstetrics and Gynecology. 15(3):240-4, 2021.07, Many fetal behaviors are thought to indicate neurological development and may be useful for predicting neurodevelopmental outcomes after birth. In the present article, we review recent fetal behavioral studies focused on early spontaneous movements, eye movements(EMs), regular mouthing movements(RMMs), expression, and our own evaluation method of fetal dysfunction. Early spontaneous movement is one of the earlier expressions of neural activity. Changes in fetal EMs are thought to reflect the development of fetal sleep. while RMMs may reflect the development of non-rapid EM sleep. Fetal facial expressions, which may reflect higher brain function, can now be observed in more detail using four-dimensional ultrasound. Furthermore, we propose that assessing fetal brain function by combining multiple behavioral indicators may predict long-term neurodevelopmental outcomes after birth.
Keywords : Eye movement, Facial expression, Fetal behavior, Mouth movement, Neurodevelopment.
3. Katayama Y, Kido S, Kai S, Nakano T, Hidaka N, Kato K, Massive atonic bleeding during cesarean delivery in a patient with chronic idiopathic intestinal pseudo-obstruction: A case report and literature review, J Obstet Gynaecol Res, 10.1111/jog.14363, 2020.08, A 35-year-old primigravid woman with chronic idiopathic intestinal pseudo-obstruction presented to our institution. Except for an enlarged fetal bladder, her pregnancy was almost uneventful until she developed pre-eclampsia requiring emergent cesarean section at 34 weeks gestation. After delivery, intractable uterine atony developed with blood loss reaching 3500 mL within 15 min. Following a B-Lynch suture, the bleeding attenuated but uterine atony persisted; lochia persisted for 3 months post-partum. The infant was diagnosed with megacystis microcolon intestinal hypoperistalsis syndrome after birth. The mother's clinical course and previous reports suggested that atonic bleeding was associated with the pathology of chronic idiopathic intestinal pseudo-obstruction; the infant's disease was considered to be maternal-related disease. Clinicians should be vigilant in pregnant patients with chronic idiopathic intestinal pseudo-obstruction especially with these complications..
4. Hara A, Hidaka N, Nitahara K, Sakai A, Kido S, Kato K, Intrathoracic shunt displacement with massive pleural effusion after successful shunt placement in a hydropic fetus with multilocular macrocystic congenital pulmonary airway malformation, J Clin Ultrasound, 10.1002/jcu.22886, 2020.06, We successfully performed shunting for a fetus with a multilocular macrocystic lung mass with hydrops at 22 weeks' gestation. Complete resolution of hydrops was achieved; however, at 35 weeks' gestation, the fetus developed acute massive pleural effusion. Fetal ultrasound examination revealed that one end of the shunting tube had migrated downward in the thoracic cavity, which led to fluid draining from the lung cyst. The baby was delivered at term and was discharged following neonatal intensive care management. Intrathoracic displacement of the shunt can occur, followed by massive pleural effusion due to drainage of cystic fluid..
5. Kai S, Fujita Y, Sato Y, Kido S, Hidaka N, Sakamoto I, Kato K, Pregnancy managed by unfractionated heparin after mechanical aortic valve replacement., J Matern Fetal Neonatal Med, 10.1080/14767058.2018.1512573, 2020.03, Pregnancy after mechanical valve replacement involves high risk. Maternal valve thrombosis and hemorrhagic complications are associated with lethal outcomes; therefore, strict anticoagulant therapy is needed. Our patient was 26-year-old primiparous woman. She had undergone aortic valve replacement with a mechanical valve at 4 years of age and had used warfarin 3 mg per day since then. Because of her desire for a baby, she stopped warfarin and conceived spontaneously. She was referred to our hospital. After being informed of her choices, unfractionated heparin (UFH) administration was started. She experienced mild heart failure with sacroiliitis, bacteremia, and hematuria during pregnancy. She delivered her newborn at 37 weeks. Blood loss at delivery was 220 g. Administration of UFH was restarted 4 h after delivery and 3 mg of warfarin was administered from postpartum day (PPD) 6. Hemostatic suturing was required for vaginal bleeding on PPD7. A therapeutic dose of warfarin was achieved on PPD9. Although warfarin use is recommended as anticoagulant therapy for pregnant woman with mechanical valves, the safety and efficacy of UFH have not yet been clarified because of its limited use. More cases are needed to clarify this..
6. Oga S¹, Hachisuga M¹, Hidaka N¹, Fujita Y¹, Tomonobe H¹’², Yamamoto H², Kato K¹, Gastric cancer during pregnancy with placental involvement: case report and review of published works, Obstet Gynecol Sci,62(5)357-61, 10.5468/ogs.2019.62.5.357, 2019.09, Gastric cancer involving the placenta during pregnancy is rare; however, we present 1 such case in this report. A 31-year-old Japanese woman was referred at 26 weeks of gestation for the evaluation of a swollen left supraclavicular lymph node. Biopsy revealed poorly differentiated adenocarcinoma, and esophagogastroduodenoscopy with biopsy of the stomach confirmed the diagnosis of gastric cancer. Her epigastric and back pain became more pronounced and her general status worsened, and we performed a cesarean delivery at 29 weeks. Microscopic examination of the placental specimen revealed poorly differentiated adenocarcinoma cells diffused into the intervillous space. Postpartum chemotherapy consisted of S-1 plus oxaliplatin. Unfortunately, this treatment was ineffective, and the patient died 3 months after delivery. The infant did well, without clinical or laboratory manifestations of metastasis. In patients with advanced gastric cancer during pregnancy, it is important to perform a microscopic examination of the placenta to evaluate for metastatic involvement..
7. Kobayashi Y, Nakano T, Hidaka N, Kato K, A rare case of fetal meconium peritonitis developing coagulopathy in utero
, J Med Ultrasound, 10.4103/JMU.JMU_25_19 , 2019.08, Hydrops fetalis in association with meconium peritonitis is a rare condition, and the mechanism underlying hydropic changes has not been fully recognized. We present a case of fetal meconium peritonitis with hydrops and coagulopathy. Clinically, the cause of fetal disseminated intravascular coagulation is considered to be a consequence of a systematic inflammatory response based on progressive, but mild fetal anemia without other apparent triggers, thrombocytopenia, elevated white blood cell count and serum C reactive-protein, hypoalbuminemia, and increased vascular permeability. The infant was born at 32 weeks of gestation and survived after postnatal multidisciplinary treatment. Our experience suggests that recognition of this rare condition will enable early diagnosis and better clinical management for fetuses with meconium peritonitis. .
8. Imachi Y¹, Hidaka N¹, Kai S¹, Hachisuga M¹, Kato K¹, Prolongation of Second Twin's Delivery Until Term : A Rare Case of Delayed-Interval Delivery, Clinical medicine & research, 10.3121/cmr.2019.1464, 2019.06, Although some cases describing delayed birth of the second twin have been published recently, delay of delivery beyond 36 weeks seems scarce. We report a case of delayed-interval delivery wherein prolongation of the second twin's delivery until term with a subsequent favorable infantile outcome. In this case, the stillbirth of the first twin occurred at 25 weeks' gestation. Prophylactic tocolysis was performed with ritodrine and magnesium sulfate, and a McDonald cerclage was performed 2 days after delivery of the first twin. Ampicillin and gentamicin were also administered for the purpose of prevention of intrauterine infection. No clinical sign of chorioamnionitis was found thereafter, and full term uneventful delivery was achieved. With this experience, we believe that delayed-interval delivery can be effective in prolonging gestation and should be an option if the first twin developed an extreme preterm delivery..
9. Minami C, Tsunematsu R, Hiasa K, Egashira K, Kato K, Successful Surgical Treatment for Congenital Vaginal Agenesis Accompanied by Functional Uterus: A Report of Two Cases., Gynecol Minim Invasive Ther. 8(2): 76-9, 10.4103/GMIT.GMIT_124_18, 2019.04, We present two cases of congenital vaginal agenesis with functional uterine corpus, manifesting with periodic lower abdominal pain and hematometra in adolescence. Both patients were successfully treated with the creation of neovagina and neocanal structures to discharge menstrual blood; this may also facilitate the preservation of fertility. Both cases were characterized by degrees of congenital vaginal agenesis, whether short or completely absent, with no communication between the uterine cavity and external genitalia, as confirmed by physical examination and imaging. We surgically reconstructed a neovagina with the modified McIndoe's procedure, using an artificial skin graft, and canalized to the caudal portion of the uterine cavity. Although redilatation of the neocanal was required, no patient suffered severe infection in postoperative course and both now exhibit regular menstruation. Although hysterectomy has classically been the preferred treatment for such cases, recent technical progression enables treatment of such diseases with conservative and minimally invasive surgery, in a safe manner..
10. Morita A , Kido S, Hachisuga M , Nagata H , Hidaka N, Kato K, Twin pregnancy complicated by total placenta previa in a Fontan-palliated patient: A case report., Case Rep Womens Health, 10.1016/j.crwh.2018.e00085, 2018.10, We present a case of a twin pregnancy in a Fontan-palliated woman that was complicated by total placenta previa. The patient was diagnosed with tricuspid atresia type II, and underwent the Fontan operation at 11 years of age. At 32 years of age, she was shown to have a dichorionic diamniotic twin pregnancy. A placenta previa was also noted. At 26 weeks' gestation, she had difficulty breathing, cardiomegaly, and worsening mitral regurgitation. At 29 weeks' gestation, an emergency cesarean section was performed, as the patient had massive genital bleeding. A postoperative cardiac catheterization demonstrated a leak from the lateral tunnel to the atrium, which was considered a cause of hypoxemia during the peripartum period. The cardiac workload in a twin pregnancy is greater, which places a Fontan-palliated patient at increased risk. Careful follow-up monitoring with multidisciplinary expertise is recommended..
11. Yoshida Y, Kaneki E, Kijima M, Kodama K, Yamaguchi S, Yagi H, Yasunaga M, Ohgami T, Onoyama I, Okugawa K, Yahata H, Sonoda K, Kato K, Two types of small cell carcinoma of the ovary: Two typical case reports. , Gynecol Oncol Rep, 10.1016/j.gore.2018.07.003, 2018.07, •This report shows very rare cases of small cell carcinoma of the ovary, hypercalcemic type and pulmonary type.•Their chemo sensitivity is quite different. These two cases followed opposite clinical courses.•The first case (SCOHT) progressed rapidly, and showed resistance to chemotherapy and radiotherapy.•The second case (SCOPT) showed sensitivity to chemotherapy and radiotherapy although recurrence was repeated..
12. Goto H, Fujita Y, Sato Y, Kido S, Ogawa M, Kato K, Prenatal diagnosis of ring chromosome 13: a rare chromosomal aberration., Perinatal Medicine, 10.1515/crpm-2017-0050, 2018.06, We report the case of a 24-year-old Japanese woman, gravida 2, para 1, who became pregnant spontaneously. At 24 weeks of gestation, her fetus was found to have various abnormalities, including holoprosencephaly, congenital heart disease and severe fetal growth restriction, and she was referred to our hospital. From these findings, the fetus was suspected of having a chromosomal aberration, in particular, trisomy 13, and after genetic counseling, amniocentesis for chromosomal analysis was performed. Although the results of fluorescent in situ hybridization (FISH) analysis showed no numeric abnormalities, G-banding analysis revealed a ring chromosome 13; 46, XX, r (13) (p13q32). At 41 weeks of gestation, she delivered a female baby weighing 2240 g with good condition. The respiratory status of the neonate was stable, and she was discharged 30 days after birth. Ring chromosomes are rare chromosomal aberrations, and obstetricians should recognize that ring chromosomes cannot be detected solely by FISH analysis and require G-banding analysis and that information on the ring breakpoint is needed to counsel the parents regarding the fetal and neonatal prognosis..
13. Fujita Y, Yumoto Y, Kato K, Prenatal diagnosis of abnormal umbilical cord insertion: a rare case of furcate insertion., J Med Ultrason, 2017.04, Furcate insertion (FI) is an extremely rare abnormality of umbilical cord insertion. One of the complications associated with FI is hemorrhage from the umbilical vein at the site of FI of the umbilical cord, which can cause sudden intrauterine fetal death. Because of its rarity, no prenatal diagnosis of FI has been reported. A 31-year-old woman at 34 weeks' gestation was referred to us for suspected abnormal cord insertion. Ultrasonography showed normal fetal growth and amniotic fluid volume, with no fetal anomalies. Although the umbilical cord contained three vessels inserted at the center of the placenta, the umbilical vessels separated from the cord substance before their insertion to the placenta. Based on these findings, the patient was diagnosed with FI. During labor at 37 weeks' gestation, fetal heart rate was normal and a healthy neonate was delivered. At macroscopic examination, the umbilical cord was inserted in the middle of the placenta, and the placental parenchymal tissue just under the cord insertion was deficient and had been changed to white, elastic hard tissue. Pathological examination of the white tissue revealed fibrin deposition and focal infarction. Although FI is a very rare condition, prenatal diagnosis can be achieved through detailed color Doppler ultrasound studies. Therefore, taking precautions and keeping in mind the poor fetal outcome associated with FI are preferred..
14. Shimada Y, Hidaka N, Maehara K, Murata M, Fujita Y, Kato K, Pulmonary thromboembolism during pregnancy in a woman with β-thalassaemia who had undergone splenectomy.
, J Obstet Gynaecol, 2016.08, β-thalassaemia are inherited blood disorders, which are characterised by reduced or no production of haemoglobin beta chains resulting in varied phenotypes, with affected individuals ranging from severely anaemic to clinically asymptomatic. Affected individuals have a risk of thromboembolic events, and the prevalence of thromboembolic events is particularly increased in splenectomized β-thalassaemia patients. However, the epidemiological data on the overall frequency of thromboembolic events during pregnancy in splenectomized women with β-thalassaemia are limited, and a case of pulmonary thromboembolism occurring during the pregnancy has not been fully described..
15. Kiyokoba R, Yagi H, Yahata H, Kawano Y, Kaneki E, Okugawa K, Sonoda K, Kato K, Tumor-To-Tomor Metastasis of Poorly Differentiated Gastric Carcinoma to Uterine Lipoleiomyoma., Obstet Gynecol, 2015.11, The rare phenomenon of tumor-to-tumor metastasis was first described in 1930. The donor neoplasm is most frequently lung or breast carcinoma, whereas intracranial meningiomas are reportedly the commonest recipient neoplasm. Here we report a case of metastasis from a primary gastric cancer to a uterine lipoleiomyoma. A 65-year-old woman presented with locally advanced gastric cancer with computed tomography (CT) evidence of peritoneal dissemination and a 9 cm pelvic mass. She underwent 16 courses of TS-1/cisplatin chemotherapy, which achieved significant tumor reduction. However, repeat CT and magnetic resonance imaging revealed a 9 cm diameter pelvic mass adjacent to the uterus. The mass was heterogeneously hyperintense on T1- and T2-weighted images with some low signal spots on fat-suppressed T1-weighted images, suggesting a benign ovarian tumor such as a mature cystic teratoma. After 3 months, pelvic CT revealed a 10 cm multilocular cystic mass that exhibited heterogeneous enhancement after intravenous contrast administration. A diagnostic laparotomy revealed a subserosal uterine tumor extending into the right broad ligament; total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. The uterine tumor showed histological features of lipoleiomyoma infiltrated by well- to moderately differentiated carcinoma cells that were similar to those of the gastric biopsy, supporting a diagnosis of metastatic gastric adenocarcinoma. .
16. Hirakawa M, Hidaka N, Kido S, Fukushima K, Kato K, Prenatal Diagnosis Using Color Doppler Sonography to Show the Passage of Diarrhea., J Ultrasound Med, 2015.11.
17. Reiko Inoue, Yasuo Yumoto, Yasuyuki Fujita, Masayuki Ochiai, Kotaro Fukushima, Kiyoko Kato, Placental chorioangioma presenting prenatal hemolytic anemia and consumption coagulopathy: a cace report., Case Reports in Perinatal Medicine, 2015.09, Large placental chorioangioma is a rare but serious complication of pregnancy. To our knowledge, this case is the first reported diagnosis of consumption coagulopathy in a fetus using fetal blood sampling (FBS) during pregnancy complicated by placental chorioangioma. A 25-year-old woman, primigravida, was referred to our hospital at 29 weeks of gestation for placental chorioangioma. At 34+1 gestation, polyhydramnios and hyperdynamic circulation were observed in the fetus. FBS demonstrated microangiopathic hemolytic anemia and the presence of consumption coagulopathy. Cesarean section was performed at 34+4 gestation because fetal maturation was expected. A female infant weighing 2158 g was born, with Apgar scores of 6 and 8 at 1 and 5 min, respectively. Neonatal blood sampling results were similar to those of FBS. The infant was treated for hyperdynamic cardiac function, hemolytic anemia, and consumption coagulopathy on mechanical ventilation in the neonatal intensive care unit and recovered fully. When fetal anemia is suspected in a case of large placental chorioangioma, the possibility of developing consumption coagulopathy during the fetal period should be considered..
18. Yuka Otera, Yasuo Yumoto, Masayuki Ochiai, Yamashita Koji, Kiyoko Kato, Prenatal diagnosis of periventricular venous infarction in utero: a cace with hereditary protein C deficiency., Case Reports in Perinatal Medicine, 2015.09, A 36-year-old primigravida woman with a normal pregnancy course presented with fetal unilateral focal ventriculomegaly on routine ultrasonography performed at 28 weeks of gestation. Periventricular venous infarction (PVI) in utero was diagnosed with fetal magnetic resonance imaging (MRI). The neonate was born at term uneventfully and in utero PVI was confirmed by MRI after birth. The neonate was diagnosed with hereditary protein C deficiency after coagulation laboratory studies. At 10 months of age, the infant presented with mild retardation of motor development. This is the first report about prenatally diagnosed PVI in utero by fetal MRI. When focal, unilateral enlargement of the ventricles is detected in utero by prenatal ultrasonography, it is important to consider PVI and perform confirmatory fetal MRI..
19. Kiyokoba R, Hidaka N, Sakata Y, Hachisuga K, Fukushima K, Kato K, Fetal cytomegalovirus infection manifesting as transient pancytopenia., Congenital anomalies, 2015.08, We encountered a patient with a fetal cytomegalovirus infection manifesting as pancytopenia and thoracic hypoplasia. The fetal anemia was treated by transfusion via the umbilical cord, and did not progress after 22 weeks' gestation. The neutropenia resolved spontaneously, and only thrombocytopenia was persistent at birth. The severe thoracic hypoplasia led to pulmonary hypertension and required intensive postnatal respiratory management. Our experience suggests that pancytopenia is a possible manifestation in fetuses infected with cytomegalovirus. This may be transient, resolving spontaneously during fetal life; however, caution should be taken with blood counts, particularly platelet counts, after delivery. In addition, clinicians should carefully follow the thoracic volume in cytomegalovirus-infected fetuses and consider the possibility of postnatal severe respiratory insufficiency..
20. Hiromi Imai, Nobuhiro Hidaka, Takeshi Murakami, Saki Kido, Yasuo Yumoto, Kotaro Fukushima, Kiyoko Kato, In utero sonographic findings of giant hepatic hemangioma and associated perinatal complications: a report of 2 cases.
, Journal of Medical Ultrasound, 2015.03, It is uncommon to diagnose fetal hepatic hemangioma during the antenatal period. We describe herein two patients with a giant hepatic hemangioma detected antenatally, both with perinatal complications. In Case 1, a fetal intra-abdominal mass, measuring 63 mm × 50 mm × 74 mm, was observed below the right lobe of the liver, and the presumptive antenatal diagnosis of hepatic hemangioma was made at 37 weeks of gestation. Antenatal imaging suggested an intratumoral hemorrhage, but postnatal clinical findings refuted this diagnosis. However, progressive thrombocytopenia and coagulopathy were noted just after birth, resulting in the diagnosis of Kasabach–Merritt syndrome. In Case 2, our ultrasound examination performed at 40 weeks of gestation revealed a mixed solid and cystic hepatic tumor, measuring 99 mm × 54 mm. Further, antenatal sonography revealed cardiomegaly, increased descending-aorta velocity, atrioventricular valvular regurgitation, and a dilated inferior vena cava, suggesting high-output cardiac insufficiency. Giant hepatic hemangiomas can lead to severe complications such as cardiac insufficiency and Kasabach–Merritt syndrome, and these complications may occur during the fetal or early neonatal period. Detailed prenatal evaluation using fetal imaging and cord-blood sampling is important to determine proper antenatal management of patients with giant hepatic hemangiomas and to allow for prompt postnatal treatment..
21. Hiromi Imai, Hiroshi Yagi, Okugawa Kaoru, Hironori Kenjo, Tatsuhiro Ogami, Yoshiaki Kawano, Kaneki Eisuke, AKIMASA ICHINOE, KAZUO ASANOMA, Hideaki Yahata, Kenzo Sonoda, Hiroaki Koayashi, Tsunehisa Kaku, Kiyoko Kato, Uterine myxoid leiomyosarcoma with tumor embolism extending into the right atrium., Obstetrics and Gynecology, 2015.02, Uterine myxoid leiomyosarcoma (MLMS) is an extremely rare variant of uterine leiomyosarcoma; only 56 cases were reported from 1982 to 2013. Uterine MLMS is characterized by a myxoid appearance and highly malignant behavior. We herein report a case involving a 65-year-old woman with uterine MLMS with a large tumor embolism that reached the right atrium. A total abdominal hysterectomy, bilateral salpingooophorectomy, and tumor embolism resection with the use of a heart-lung machine were performed. Epirubicin-ifosfamide chemotherapy in the adjuvant setting led to reductions in both the tumor emboli and peritoneal dissemination. The patient retained a good quality of life for 10 months after the initial surgery. She then developed progressive disease despite treatment with pazopanib. She died of her disease 14 months after the initial surgery. Although complete surgical resection of the tumor is desirable, tumor reduction surgery followed by adjuvant chemotherapy might help to retain a good quality of life. This is the first reported case of a primary uterine MLMS with tumor emboli. .
22. Shoko Wakimoto, Nobuhiro Hidaka, Kotaro Fukushima, Kiyoko Kato, Spontaneous post-partum rupture of an ovarian artery aneurysm: A case report of successful embolization and a review of the published work., 2014.09, It is rare for an ovarian artery aneurysm to rupture during the peripartum period, but the outcome can be catastrophic. Between 1980 and 2013, only nine cases have been reported in the English-language medical published work. We describe a patient with a left ovarian artery aneurysm that ruptured 4 days after an uneventful vaginal delivery. The rupture was immediately identified, using emergent computed tomography and angiography. The hemorrhage was managed using arterial embolization and blood transfusion, allowing for a successful outcome. The possibility of ruptured ovarian artery aneurysm should be considered in the differential diagnosis for women with excessive or localized abdominal pain after childbirth..
23. Tomoka Jimbo, Yasuyuki Fujita, Yasuo Yumoto, Kotaro Fukushima, Kiyoko Kato, Rare fetal complications associated with placental mesenchymal dysplasia: A report of two cases., J Obstet Gynaecol Res doi: 10.1111/jog.12518. : 1-5, 2014.09, Placental mesenchymal dysplasia (PMD) is a rare disease that may be difficult to distinguish from molar pregnancy. The disease is associated with major fetal complications, including Beckwith-Wiedemann syndrome, fetal growth restriction and intrauterine fetal death. Rarely, fetal hematological disorders and liver tumors also may occur. Two patients were referred to our hospital during their second trimesters because of suspected molar pregnancies. Fetal karyotyping and maternal serum human chorionic gonadotropin level determinations led to the PMD diagnoses. In one case, the maternal clinical course was normal, but the neonate suffered from disseminated intravascular coagulation and needed a platelet transfusion. In the second case, the PMD decreased during pregnancy, but a gradually increasing fetal liver tumor appeared. The tumor was diagnosed as mesenchymal hamartoma, based on ultrasound and magnetic resonance imaging studies. The neonate was delivered without cardiovascular compromise. Due to the difficulty of immediate surgical treatment, expectant management, with close follow-up, was chosen..
24. Masanori Suenaga, Nobuhiro Hidaka, Yuka Otera, Kotaro Fukushima, Kiyoko Kato, Successful ex utero intrapartum treatment procedure for prenatally diagnosed severe micrognathia., J Obstet Gynaecol Res , 40(8): 2005-2009, 2014・4451, 2014.08, We present a case of fetal severe micrognathia in which successful airway stabilization was achieved by an ex utero intrapartum treatment procedure. In this case, it was anticipated that the infant would have a vulnerable airway at birth based on in utero sonographic findings, including an extremely hypoplastic jaw, worsening polyhydramnios and absence of stomach visualization. Early sonographic recognition was helpful in preparing the parents and physicians for the possibility of airway emergencies during the perinatal period. When a severely hypoplastic mandible accompanied by polyhydramnios and absent stomach visualization is noted on ultrasound, clinicians should consider the indication for ex utero intrapartum treatment. A multidisciplinary team with technically skilled medical providers should be coordinated to perform the procedure. .
25. Tomonobu Uozumi, Yasuyuki Fujita, Kiyomi Tsukimori, Naoki Fusazaki, Toshihide Nakano, Hideaki Kado, Yukiko Chinen, Masato Kamitomo, Makoto Nishibatake, Kiyoko Kato, Prenatal ultrasonographic diagnosis of uhl anomaly. , Perinat Med 1-4,, 2014.07, Uhl anomaly is an extremely rare condition, and herein, we present a case of prenatally diagnosed Uhl anomaly to illustrate the associated echocardiographic features. Fetal echocardiography at 26 weeks indicated an enlarged right ventricle, severe tricuspid and pulmonary regurgitation, and ruptured ventricular septal aneurysm, resulting in a circular shunt. At 36 weeks, based on the presence of a thin ventricular wall and absence of apical trabeculation, a diagnosis of Uhl anomaly was made. The neonate, delivered by cesarean section, underwent main pulmonary artery ligation to eliminate the circular shunt immediately after birth. Moreover, he underwent ductus arteriosus ligation and received a pulmonary artery to aorta shunt for progressive lung congestion. He is currently well and awaiting a staged Fontan operation involving a bidirectional Glenn procedure. Understanding and accurate prenatal diagnoses of Uhl anomaly may help in parental counseling, planning appropriate perinatal care, and increasing the chances of survival..
26. Ayasa Nonaka, Nobuhiro Hidaka, Saki Kido, Kotaro Fukushima, Kiyoko Kato, Prenatal imaging of a fetus with the rare combination of a right congenital diaphragmatic hernia and a giant omphalocele.
, Congenit Anom (Kyoto) doi:10.1111/cga.12075:1-17, 2014.07, A co-existing right congenital diaphragmatic hernia and omphalocele is rare. We present images of a fetus diagnosed with this rare combination of anomalies. Early neonatal death occurred immediately after the full-term birth due to severe respiratory insufficiency. In this case, disturbance of chest wall development due to the omphalocele rather than the diaphragmatic hernia was considered as the main cause of lung hypoplasia. Our experience suggests that caution should be exercised for severe respiratory insufficiency in a neonate with an omphalocele and diaphragmatic hernia, even in the absence of an intra-thoracic liver, one of the indicators of poor outcome for congenital diaphragmatic hernia..
27. Keiko Kawamura, Kaneki Eisuke, Shinji Ogawa, Hiroko Imamura, Yoshihiro Ohishi, Hiroaki Kobayashi, Kiyoko Kato, Primary Uterine Müllerian Mucinous Borderline Tumor (MMBT) Associated With Adenomyosis: A Case Report, Int J Gynecol Pathol, 33(2): 146-150, 2014.03.
28. Kiyoko Kato, Endometrial cancer stem cells: a new target for cancer therapy, Anticancer Res. 32(6),2283-2293,2012, 2012.06.
29. Kiyoko Kato, Stem Cells in Human Normal Endometrium And Endometrial Cancer Cells: Characterization of Side-Population Cells, Kaohsiung Journal of Medical Sciences. 28(2), 63-71, 2012, 2012.02.