Hisanaga's scientific contributions

Scientific contributions of Kohzoh Hisanaga(Hisanaga,K) about transesophageal echocardiography (TEE) and endoscopic ultrasonography(EUS)

Address of Kohzoh Hisanaga(Hisanaga,K)

 

E-mail correspondence     busuchan1122@yahoo.co.jp

 

There are many transesophageal two-dimensional echocardiographic images and images of endoscopic ultrasonography in this website.

In all Hisanaga's transesophageal systems, tube with transducer was flexible (not rigid) and easy swallowing by patients.

 

When you have the time, please see "Time line of development of EUS and TEE".     Click here

Please see "History of Echocardiography".     Click here

Please see "History of Transesophageal Echocardiography".     Click here

Please see "History of Endoscopic Ultrasonography".     Click here

 

Address

Kohzoh Hisanaga(Hisanaga,K) M.D.

Hisanaga Medical Clinic 

59 Isegaeri Takao Fusouchou Niwagun Aichiken 480-0102 Japan

 

Tel : 81-587-93-8372 (81587938372)

Fax : 81-587-93-8372 (81587938372)

 

Scientific contributions 

Anybody can reproduce photographs from this website without permission of Hisanaga.

E-mail correspondence      busuchan1122@yahoo.co.jp

 

Medical Doctor Hisanaga himself developed all transesophageal and transgastric systems without help of any electric companies or organizations except that of Asako Hisanaga.  Apart from gagging, no serious complications were encountered in all transesophageal and transgastric examinations by Hisanaga.

 

No. 1      Hisanaga K, Hisanaga A, Nagata K, Yoshida S.    A new transesophageal real-time two-dimensional echocardiographic system using a flexible tube and its  clinical applications.   Proceedings of the Japan Society of Ultrasonics in Medicine  32:43-44, 1977

From No.1    Transesohageal hoorizontal scan in a 26 years old normal female. 

No. 2     Hisanaga K, Hisanaga A, Nagata K, Ichie Y, Yoshida S.   A new transesophageal real time high speed linear scanner and its clinical applications.  Proceedings of the Japan Society of Ultrasonics in Medicine  33:47-48, 1978

From No.2    Transesophageal vertical scan through mitral valve in a normal adult. 

No. 3      Hisanaga K, Hisanaga A.   A new real-time sector scanning system of ultra-wide angle and real-time recording of entire adult cardiac images --- Transesophagus and trans-chest-wall methods ---.   In:White DN, Lyons AE, eds.  Ultrasound in Medicine. Vol.4. New York; Plenum Press, pp391-402, 1978

From No.3    Fig.5   Insertions of transducer to esophagus and transesophageal ultrasound examinations were performed with patients in left lateral position(left). Typical horizontal scan in a 26-year-old normal adult by using transesophageal method (right).                                                            

From No.3    Fig.6    Transthoracic method.   A long axis scan in a 31-year-old normal man.   Entire heart image is seen.   The endocardium of the left ventricle and the right ventricular anterior wall are seen.                            

From No.3   Fig .9   Transesophageal M-mode echograms.   These images were recorded in order to identify echo sources of transesophageal cross-sectional images shown in Fig.10.  Arrows A,B and C of Fig.10A and Fig.10D correspond to Fig.9A, 9B and 9C in each and show directions of M-mode echograms.                                  

No.3A    Hisanaga K, Hisanaga A, Ngata K, Ichie Y,Yoshida S.     Transesophageal cross-sectional echocardiography  ---New method for cardiac diagnosis--- (abstr.)  Jp Circulation J(Circulation Journal)42:773, 1978

No.4     Hisanaga K, Hisanaga A.   A new transesophageal high speed sector scanner.  Abstracts of 3rd European Congress on Ultrasonics in Medicine (3rd Congress of EFSUMB) pp201-205, October 1-5, Bologna, 1978 

From No.4    Transesophageal horizontal scan at the level of aortic valve in a normal adult. 

No. 5    Hisanaga K, Hisanaga A.   A new trans-digestive-tract scanner with a gastrofiberscope.  Proceedings of the 23rd Annual Meeting of American Institute of Ultrasound in Medicine.  p.108, November, 1978,  San Diego

No. 6    Hisanaga K, Hisanaga A.   A new trans-digestive-tract scanner with a gastrofiberscope.  Reflections 4:221, 1978

No. 7    Hisanaga K, Hisanaga A.   A transesophageal real-time sector scanner with an oil filled cell.   Proceedings of the 23rd Annual Meeting of American Institute of Ultrasound in Medicine. p.47, November, 1978, San Diego

No. 7A    Hisanaga K, Hisanaga A.   A new transesophageal real-time sector scanner with an oil filled cell.    Reflections 4:192,1978

No.7B    Hisanaga K, Hisanaga A.   A new transesophageal real-time linear scanner and initial clinical results.   Proceedings of the 23rd Annual Meeting of American Institute of Ultrasound in Medicine.  p.112, November, San Diego, 1978   

No. 8    Hisanaga K, Hisanaga A, Ichie Y.   A new transesophageal real-time linear scanner and initial clinical results.    Reflections 4:203, 1978  

No.8A     Hisanaga K, Hisanaga A, Nagata K, Ichie Y, Yoshida S.   A new auto-sweeping system for transesophageal M-mode scan and its clinical applications.  Proceedings of the Japan Society of Ultrasonics in Medicine  33:45-46, 1978

From No.8A    Transesophageal horizontal sweeping in a normal adult at the level of mitral valve.

From No.8A    Transesophageal horizontal sweeping in a normal adult at the level of aortic valve. 

No. 9    Hisanaga K, Hisanaga A.   A transesophageal pulsed Doppler echocardiographic system and initial clinical results.   Proceedings of the Japan Society of Ultrasonics in Medicine  34:9-10, 1978

No. 10    Hisanaga K, Hisanaga A, Ichie Y, Nishimura K, Hibi N, Fukui Y, Kambe T.    Transesophageal pulsed Doppler echocardiogrphy.   Lancet 1:53 - 54, 1979         

No. 11   Hisanaga K, Hisanaga A, Nagata K, Ichie Y.     A trans-stomach wall sector scanner with a gastrofiberscope.     Abstract of 2nd WFUMB, p383, July 22-27, Miyazaki, 1979 

No. 11A  Hisanaga K, Hisanaga A.   A new transesophageal radial scanner using a rotating flexible shaft and initial clinical results.    Proceedings of the 24th Annual Meeting of American Institute of Ultrasound in Medicine. p.122, August 27-31, Montreal, 1979 

No.12    Hisanaga K, Hisanaga A, Nagata K, Ichie Y.   A trans-stomach-wall high speed rotating scanner and initial clinical results.    Proceedings of the Japan Society of Ultrasonics in Medicine  35:115-116, 1979

Photography of original paper                            

From No.12       Fig.2  Trans-stomach-wall high speed rotating scanner. 

From No.12   Fig.3   Horizontal scan through the left kidney in a normal adult by using the trans-stomach-wall rotating scanner.   When near gain is standard.  Pancreas is seen as echo free space  near the esophagus.           

12A.   Hisanaga K, Hisanaga A.   High speed rotating scanners for trasesophageal echocardiography and transgastoric sonography.    Eizou Jouhou Medical 11:1094-1099, 1979 (In Japanese)

From No.12A     Transgastric high speed rotating scanner with flexible tube. 

From No.12A    Horizontal scan at the level of kidney in a normal adult.  Pancreas is seen very clearly. 

No.13     Hisanaga K, Hisanaga A, Nagata K, Ichie Y.   Cardiac imaging using a transesophageal ultrasound high speed rotating scanner.     Proceedings of the Japan Society of Ultrasonics in Medicine  35:157-158, 1979

From No.13     Transesophageal high speed rotating scanner 

From No.13     Transducer and commutator in oil bag. 

From No.13     Horizontal scan at the level of the mitral valve in a patient with severe mitral stenosis by using the transesophageal high speed rotating scanner.  Anterior and posterior mitral leaflets are thickened.                                                                     

No.14     Hisanaga K, Hisanaga A, Fukui K, Nagata K, Ichie Y, Isaji F.   Atrial septal  defect visualization by transesophageal cross-sectional echocardiography.    Proceedings of the Japan Society of Ultrasonics in Medicine  35:51-52, 1979

From No.14    Fig.1  Preoperative horizontal scan at the level of the mitral valve in a patient with atrial septal defect by using  a transesophageal high speed sector scanner. ( case 1) D = defect.                

From No.14    Fig.3 postoperative horizontal scan at the level of the mitral valve in the patient as show in Fig.1 and2 by using  a transesophageal high speed rotating scanner (case 1). 

No.15     Hisanaga K, Hisanaga A, Ichie Y.   A transesophageal ultrasound sector    scanner for oblique scans (abstsr).    Circulation 60 (suppl II):II-245, 1979. 

No.16     Hisanaga K, Hisanaga A, Kambe T.   Transgastric sonography and examination technique.    Proceedings of the Japan Society of Ultrasonics in Medicine 37:413-414, 1980

This is the most important technique in EUS examination.

Filling stomach with water method.

Photography of original paper                    

From No.16   Fig.1    Diagrammatic illustration of the transgastric ultrasound sector scanner with gastrofiberscope.

From No.16   Fig.2    Transgastric ultrasound sector scanner with gastrofiberscope (Olympus GIF type Q).

From No.16   Fig.3  Horizontal scan through the stomach posterior wall in a normal adult by using the transgastric sector scanner  with gastrofiberscope when the stomach was filled with water.    Left kidney is seen clearly.   SW = stomach wall, LK = left kidney, V = vertebra, R = right, L = left.    

Content of this paper is filling stomach with water during EUS  examination in order to increase acoustic contact          between stomach wall and transducer.  Hisanaga performed this method for the first time in the world certainly.  This is the most important discovery in EUS examination.  

No.16A     Hisanaga K, Hisanaga A.     Endoscopic ultrasound system with optical fiberscope and exaination technique ---filing stomach with water method---, Eizou Jouhou Medical (in Japanese) Vol.12, No.13, pp773-776, August 1980

No.17     Hisanaga K, Hisanaga A, Nagata K, Ichie Y.    A transesophageal high speed rotating scanner for oblique scans and long axis cardiac images including apex.    Proceedings of the Japan Society of Ultrasonics in Medicine  36:395-396, 1980

From No.17   Transesophageal inferior oblique scan through the apex in a normal adult.  Cross-section is angled downward about 40 degrees from the horizontal plane.  The entire heart including the apex is seen.

No.19     Hisanaga K, Hisanaga A.   Pancreatic echography using a trans-stomach wall ultrasound rotating scanner (abstr).   Gastroenterology 78:1183, 1980

No.20     Hisanaga K, Hisanaga A, Kambe T.   An endoscopic ultrasound scanner for abdominal echography (abstr).   Gastrointestinal Endoscopy 26:68, 1980         

No.21     Hisanaga K, Hisanaga A, Nagata K, Ichie Y.   High speed rotating scanner for transgastric sonography.   Am. J. Roentgenol. 135:625-629, 1980

From No. 21   Upper Fig.    Intragastric high speed rotating scanner.  Small transducer in stomach is rotated by flexible rotating  shaft and motor at 15-50 cycles/sec.     Lower Fig.    Transducer and commutator in oil bag.                            

     Left                                                                       Right

From No.21    Horizontal scans through left kidney in normal adult with intragastric high speed rotating scanner.  

Left : Left kidney and abdominal aorta are seen clearly.  If amplitude of near field is relatively low, pancreas is seen as anehoic  

space near stomach wall.       Right : With increasing amplitude of near field, pancreas assumes cloudlike shape.

No.22     Hisanaga K, Hisanaga A, Nagata K, Ichie Y, Isaji F.   Transesophageal cross-sectional echocardiographic diagnosis of Lutembacher's  syndrome.    Proceedings of the Japan Society of Ultrasonics in Medicine  37:179-180, 1980

From No.22   Fig. 4   Transesophageal cross-sectional echocardiogram before surgical repair in a patient with Lutembacher's

syndrome..  Cross-section is horizontal.        ESO = esophagus,  D = defect, LA = left atrium, LV = left ventricle, RA = right atrium, RV = right ventricle.

From No.22   Fig.5   Transesophageal cross-sectional echocardiogram after surgical repair in a patient with Lutembacher's syndrome.  Cross-section is horizontal.   Interatrial septum is seen continuously .       IAS = interatrial septum.                            

No.23     Hisanaga K, Hisanaga A, kambe T.   Detection of atrial septal defect by transesophageal two-dimensional echocardiography(abstr).       Circulation. 62:(suppl III):III-34, 1980

No.24     Hisanaga K, Hisanaga A, Nagata K, Ichie Y.   Transesophageal cross- sectional echocardiography.   Am. Heart J. 100:605-609, 1980

From No.24    Transesphageal horizontal scan at the level of the aortic valve .  The aortic cusps are closed in diastole. Large left atrium is seen .  Right ventricular outflow tract is seen anterior to the aorta.            AV = aortic valve,  RVOT = right ventricular outflow tract.                                              

From No.24     Trans esophageal vertical linear scan through the pulmonary artery in a normal subject. Bifurcation of pulmonary artery and part of ascending aorta are seen.          AO = aorta, PA = pulmonary artery , BI = bifurcation of pulmonary artery.        

No.25     Hisanaga K, Hisanaga A, Ichie Y, Hibi N, Nishimura K, Kambe T.   High speed rotating scanner for transesophageal cross-sectional echocardiography.     Am. J. Cardiol.  46:837-842, 1980

From No.25    Diagrammatic illustration of the transesophageal high speed rotating scanner.  A small transducer in the esophagus is rotated through a full 360° through a flexible shaft by a motor at 15 to 50 cycles /s.   Although the small trasducer is  rotated with great speed in the patient's esophagus, no damage results because the transducer is safely enveloped in an oil bag.

From No.25   Transesophageal high speed rotating scanner.

From No.25    Transducer and commutator in oil bag.  Sound energy is coupled to and from the transducer through the slip-ring  commutator because of the full 360° rotation of the transducer.

From No.25     Transesophageal cross-sectional echocardiograms in a patient with mitral stenosis.  The cross section is horizontal  and shows the heart as viewed from the cardiac apex.  A : a frame during diastole and B : a frame during systole.  A stenotic mitral orifice(in A) is seen between the tips of the thickened mitral leaflets.  The interatrial septum (IAS) is seen without dropout.    AML = anterior mitral leaflet.  ESO = esophagus,  IVS = interventricular septum, LA = left atrium, LV = left ventricle,  PML = posterior mitral leaflet, RA = right atrium, RV = right ventricle, TV = tricuspid valve.

No.26     Hisanaga K, Hisanaga A.   Measurement of defect size of atrial septal defect by transesophageal two-dimensional echocardiography.    Proceedings of the Japan Society of Ultrasonics in Medicine  38:5-6, 1981

Photography of original paper

From No.26  Table 1 Ten patients studied and results.

From No.26   Comparison of defect size(operative findings) with transesophageal 2D ECHO measurements.

From No. 26    Fig.2    Transesophageal two-dimensional echocardiogram in a patient with an ostium secundum atrial septal defect.  Cross-section is horizontal.     D - defect.         

No.27     Hisanaga K, Hisanaga A,Isaji F.   Transesophageal two-dimensional echocardiographic  diagnosis of left atrial myxoma.      Proceedings of the Japan Society of Ultrasonics in Medicine  39:457-458, 1981

From No.27     Transesophageal two-dimensional echocardiogram in a patient with a left atrial myxoma.   Cross section is horizontal.  A stalk of the tumor is seen clearly.    K = stalk.  

From No.27    Fig.5  Extracted tumor.  Weight of the tumor was 38.5g. 

No.28     Hisanaga K, Hisanaga A.   Findings of coronary artery by transesophageal two-dimensional echocardiography.     Proceedings of the Japan Society of Ultrasonics in Medicine  40:171-172, 1982

From No.28   Transesophageal two-dimensional echocardiogram in a patient with both aortic regurgitation and mitral stenosis.  LCA = left coronary artery, RCA = right  coronary artery.     

No.28A    Hisanaga K, Hisanaga A.   Transesophageal pulsed Doppler echocardiography (Third report): Development of system without mirror and initial clinical results.   Proceeding of the Japan society of ultrasonics in Medicine 40:399-400, 1982

No.29      Hisanaga K, Hisanaga A.   Transesophageal cross-sectional echocardiography with mechanical scanning system.    In Hanrath, Bleifelt and Souquet, eds.  Cardiovascular Diagnosis by Ultrasound.  Martinus Nijhoff Publishers, pp239-245,1982   

There is this paper in internet.    In internet, as references of my paper appear at first, please scroll down, then my full paper will appear.        Please click here

From No.29    Fig.6   Horizontal scan in a normal adult.  A part of aorta (A) is seen.    There is this paper in internet.  In internet, as references of my paper appear at first, please scroll down, then my full paper will appear.        Please click here

No.30     Hisanaga K, Hisanaga A.   Visuarization of coronary artery by transesophageal two-dimensional echocardiography (2nd report).    Proceedings of the Japan Society of Ultrasonics in Medicine  41:715-716, 1982

From No.30    FIg.2  Traansesophageal two-dimensional echocardiogram of a patient with mitral stenosis.   Image shown by arrow A is probably left coronary artery.                            

 

Apart from gagging, no serious complications were encountered in all transesophageal and transgastric examinations by Hisanaga.  Medical Doctor Hisanaga himself developed all transesophageal and transgastric systems without help of any electric companies or organizations except that of Asako Hisanaga.