Star wars episode 7

I went to a movie theater with my children to watch Star wars episode 7

It was exciting because of the exceptional CGIs. On top of that, I understand that the saga is getting thicker and thicker. I cannot wait for the next episode.

It is new year's eve today, so we are going to have a big meal with my parents and my brother's family.

How nice today is, although I will have to work at my hospital as a duty doctor tomorrow or new year's day..

Anyway, thank this year for everything that occurred around me. May the force be with you and me.

Bowling

My two children and I enjoyed bowling this evening.

This is my first time in about 10 years. Actually, I did not play bowling myself, but my daughter and son did 2 games of bowling.

Their scores were not good, about 70 points per game, but seems interested in bowling probably because the rule was easy to master and the dynamic motion of balls and 10 pins was exciting to them.

I am looking forward to playing bowling with my kids again in the near future.

Vegitable intakes

I am not a picky eater. I love fish, meet, as well as vegetables. On this point, I have to thank my parents because they never allowed me to avoid some kinds of ingredients for my good health.

I do not mean to insist the importance of vegetables, which are usually least favorable food for children and adolescents.

I do not think that I have enough vegetable intakes because it is not a easy task to prepare fresh vegetables. Recently, I sometimes drink a vegetable juice instead of eating.

It is very convenient and handy, but not tasty. It would be appreciated if I could take a small, tasty pill that includes a lot of vegetable ingredients inside.

OMG

I remember this blog just before I go to bed.

When I started this blog, I decided to submit every day whatever it is. This is why I try to write something, although I almost fall asleep.

I love sleeping because I always have a dream during sleep and remember what it was after getting up.

So, I promise tomorrow I would submit a blog about the dream I would have tonight.

My son's work

All of a sudden, my younger son came to me and asked, "Dad, are you OK?"


I said, "It's OK," although I was not sure what he was asking. Then, he picked up a blue pen from his pocket, and started drawing something on the back of my left hand.

A few minutes later, I found that he tried to draw Doraemon, a famous cartoon character.

I was so impressed because his behavior was not only cute but also the Draemon he drew was really cute.

Unfortunately, it seems like that he used an oil-based pen to draw it, so it never disappeared after taking a bath. However, it would be OK because I am always proud of my kids.

My concern is why he drew Draemon on my hand, but I am still unaware.

My birthday

I am stuffed.

Today is the day after Christmas as well as my birthday. My three children and I had a big meal that my wife cooked for us. It was so delicious as usual.

My elder son gave me a coin folder. My younger son's present was a small, smoked glass, which I used tonight to drink a red wine.

On top of that, I got rubber bands from my daughter. These goods are what I have been wanting to have at work. They are usually put on fingers and really helpful when I check a pile of reports.

I guess you could say that I am very happy. I really hope so. Thanks, every body.

Codes

I did it. I had been suffering from writing a specific program without success. This morning, however, I have finally completed this tough task.

What I wanted to do is to write codes that keep the status of radiobuttons even when you move to another page. I tried to do it with a jquery of cookie, but did not succeeded in it.

I changed my way and happily did it with a technique called localstrage.

What is the fantastic moment when it comes to writing codes is when I see my program working as I though it would. The moment occurred early in this morning. That made me so really excited and, no wonder, made my day

I guess, the more the task is tough, the more you can have fun.

School reports

The second term was finished at elementary school that my two children attend.

They went back home with their school reports. After having dinner, I checked them and found some subjects better than the first term, altough some were worse.

As usual, I praised my kids because they went to school every day. I have to admit that it is important to get good grades at school, but what is more important is not to be absent from school.

I want them to know that they have to thank for their good health.

National holiday

Today is a national holiday in Japan, the birthday of the Japanese Emperor.

I have never forgotten his birthday because it is a day before Christmas day and 3 days before my birthday, December 26th. As a child, I did not like my birthday since it was in the middle of a winter vacation, but now, it does not matter to me because I have no winter vacation, although we do not have to work around the year end.

I did not go out today. One reason is it has been raining since early in the morning. Another reason is I had a bunch of things to do. I spent more than 10 hours writing codes for a website of cardiopulmonary exercise or CPX.

A sedentary life style is not good for my health, so I played a lot with my daughter and the younger son indoors.

I am so satisfied with the national holiday.

365

The other day, I attended a local scientific meeting that is held twice a year, early summer and late autumn.

When I arrived at the conventional center, I put my coat in the cloakroom and got this blue plate, as shown in the left, in exchange for my clothes.

I was a little glad to have this plate because its number said 365, which is the same days as a year. Of course, I know it would not make any sense but, when I think positive, it could make my day. Actually, my presentation at the conference was better than I would expect.

To look on the bright sides of things is what I really want my three kids to have in the future.

Water vs. Tea

Most Japanese drink tea (not always green tea), instead of water, during meals. In my case, alcoholic beverages more commonly come with dinner, though.

Recently, my 12-year-old daughter has started to drink water at the table. She said that water is good because it keeps her teeth whiter. She added that avoiding drinking tea is common sense among her friends. As expected, my two sons do not accept the concept.

I am not sure if there is evidence to show the association of drinking water with darkening teeth, although the relationship is intuitive. If so, a red wine would be more tightly connected to change in color of teeth, because my teeth look dark after having dinner with red wine.

I may know the answer 10years later, when I compare the color of teeth between my three children.

Wedding party

Today, I attended a wedding party for my ex-colleague. He got married to a beautiful pianist. Congratulations.

When I was young, I attended a lot of wedding parties, but this was for the first time in five or six years. The ceremony was way much better than I though it would be. I had a lot of fun with a good food and drink as well as talks with my friends.

What was best is the mood of the ceremony was so good. I am sure that they would be a good couple.

CPX

CPX means cardiopulmonary exercise, which is a medical test to examine the cause of shortness of breath.

CPX test is clinically important but unlikely to be popular in Japan, probably because it is not easy for medical staff to interpret the results of CPX test.

Some textbooks have been available to learn CPX, but these books did not work well while I was struggling to learn. So many variables and graphs associated with CPX analysis made me confused.

From my bad experience, I decided a few days ago to create a website where the non-experienced are able to learn about CPX more easily and efficiently. Needless to say, it is for free.

It would take me several months to complete, but I will not give up.
If sounds intesting to you, visit here and enjoy the process of creating the website.

AME HO

I have heard that one of my favorite podcasts, American Hot Topics or AME HO, won the best podcast award on iTunes in 2015.

Congratulations!

This podcast releases one episode a week, where you can enjoy sophisticated conversations between Jun, who is Japanese and an English learner, and Aaron, an American who teaches English at a college in Japan.

I started to listen to the podcast several months ago. One good thing about the AME HO is that the topics are really attracting. On top of that, the English that the two guys speak sounds fun to me, although it is a little hard to follow.

What surprises me most is Aaron's ability to understand the Japanese that Jun speaks, where there are so may slang words and difficult expression even to native Japanese people, but Aaron seems to catch what Jun says.

Newspaper

I am worrying...
It may be a small thing, but it has bothered me.

Yesterday, I wrote in my blog, "I read the newspaper." This simple sentence is what makes me feel uneasy. The point is I do not know if "the" is necessary before "newspaper".

When I try to express such a situation, there can be three ways as follows.
 A: I read the newspaper.
 B: I read a newspaper.
 C: I read newspaper.

I know that a word of newspaper is a countable noun, thus sentence C sounds unnatural to me. I believe that my guess is right.

My feeling says what is right is sentence A, although I can not explain the reason well. It would be fantastic if I could choose the right sentence without thinking one year later.

Door-to-balloon time

Have you ever heard of a phrase called "door-to-balloon time"? This is the time interval between patient's arrival and the start of angioplasty using balloons in the case of heart attack.

It is no secret that time matters in the management of acute myocardial infarction. The shorter the door-to-balloon time is, the better the outcome is, because myocardium starts dying gradually and steadily since the culprit lesion of the coronary artery is occluded.

Actually, in the medical insurance in Japan, the hospital income is higher with a door-to-balloon time of 90 minutes or shorter than over 90 minutes among patients with acute myocardial infarction.

By the way, bed-to-door time, which is the period between I get up and leave home in the morning, is also important to me. Since there have been so many things to do on my plate, I have to go to my office as early as could. My bed-to-door time is usually about 20 minute, when I change my clothes, blush my teeth, and shave my face.

I am sorry that I do not have enough time to eat breakfast and read the newspaper.

mmHg and mm Hg

Which do you prefer?

A: Your blood pressure is 140/80 mmHg.
B: Your blood pressure is 120/70 mm Hg.

I am not talking about the blood pressure but the unit of blood pressure (i.e., mmHg versus mm Hg). The two ways to describe the unit of blood pressure may be minimal; the former has no space between mm and Hg, whereas there is a space in the latter.

I believe that most doctors consider mmHg common, but let me explain the basis of the unit, mmHg. As you know, mm means millimeter and Hg is a symbol of a chemical material, mercury. I am still wondering if the combination of two different staffs makes any sense? Don't you think they look more academic when separated?

Actually, in the New England Journal of Medicine, which is the top journal in the field of clinical medicine, "mm Hg" is adopted instead of "mmHg", although almost all other medical journal use a unit of mmHg when it comes to blood pressure. 

Tombstone-like ECG

Some electrocardiograms or ECGs have another name that has nothing to do with cardiology.

Here is a good example. This ECG was obtained in the acute phase of anterior myocardial infarction. You can see significant ST-segment elevation in leads V1 to V6.

Take a close look at the shape of ST-T segments especially in V2 or V3 lead. Don't you think that it looks something familiar to you?

Fish? No. thumb? Wrong. Roof? Non.

Believe it or not, it is often described as tombstone-like. Do you agree? Dose that make any sense to you?

For me, it is not the name that counts, because this kind of ECG indicates an medical emergency. I have to perform angioplasty, as soon as possible, to save the patient who is suffering from a critically ill condition

Agar

My young, 8-year-old son never gets tired of a video game called Agar.

Basically, in Agar, you are a gelatinous colloid or an agar. The rule is very simple, so-called the jungle law. You need to eat other agars to grow up. The game is ceaseless and will finish when you are eaten by another agar.

The point is a good balance of the game; the bigger you are, the slower you move. That means the game is fun regardless of your size.

You can download the app from Apple store and play it for free. The game may be available from Google play.

Give it a try if you are interested in the world of Agar, but try not to waste your time because you may be addicted, like my son.

My ECG

Take a look at this electrocardiograpy or ECG, and tell me your diagnosis.

This ECG is mine. I do not mean that it is in my collection. This is an ECG of my heart.

My diagnosis is left ventricular high voltage. Some consider it left ventricuar hypertrophy or LVH, but I recommend that a diagnosis of LVH be done when accompanied with ST-T chanages.

Echocardiography is considered in the case of LVH, but not always for left ventricular high voltage, given the sensitivity and specificity of ECG.

Maybe funny, but I have never checked my heart using echocardiography although I am a cardiologist.

120 versus 140 mmHg

Recently, an interesting research about blood pressure has been released in the New England Journal of Medicine.

This large, randomized, clinical trial or the SPRINT trial was performed to determine the most appropriate target for systolic blood pressure to reduce cardiovascular morbidity and mortality in patients without diabetes.

The trial was stopped before the initial plan because a systolic blood pressure of <120 mmHg, as compared with less than 140 mmHg, was associated with significantly lower rates of cardiovascular events and death from any cause.

Although we have to pay attention to side effects related to intensive blood-pressure control, such as hypotension or acute renal injury, the results of the SPRINT trial may affect the guidelines of blood-pressure control among selected patients.

You can access the full text at this link.

Movie GIF

This is a picture, not a movie, although you see the image moving. The format is so-called Movie GIF.

I do not know much about the way on how to compile images into an animation, however it is no wonder that Movie GIF is useful when you create a website because of its simplicity.

It is a little bit tough to handle movie files, as compared with image files, on the Internet. Program codes can get more complicated because computers clearly differentiate a image file from a movie file.

By the way, this icon of three people with their arms around each other's shoulders reminds me of my three children, who are really getting along well so far. I hope they help out each other even after they grow up.

Multitasking

I am not good at multitasking, although I think that I have the ability to focus on something.

It is said that women are better than men in terms of multitasking. Some researchers say that it may be due to anatomical and functional differences in the brain between men and women.

The brain is composed of two parts, the right hemisphere and the left hemisphere. Women seem to have a tighter connection between the two parts than do men, although I am not sure if this concept has been established among experts.

I am not familiar with the field of the brain, but the idea makes sense to me because my wife has a good ability to multitask. She is able to reply to my asking even during her daily chores. On the other hand, while I am doing something at home, I can not appropriately respond to her questions.

Some people say that mother's circumstances make women more competent in multitasking. However, multitasking abilities have been with my wife before she became a mother, I think.

To be lefty

I am a right-handed person. The rest members of my family are right-handed, as well.

Several months ago, I started to brush my teeth using my left hand. It was not easy task and my gum often was injured because of my rough brushing. However, I have been getting used to it little by little, and now, I have no difficulty brushing my teeth with my left hand.

In my opinion, left-handed persons tend to look cool. It is unclear whether my lefty preference is associated with Keanu Reeves, a leading actor in my favorite movie, the Matrix.

You may ask me what has happened to me with the new skill (i.e.,  left-handed teeth-brushing). Does my family start to think that I look cooler than ever before?

Off course not, but to obtain a new technique, whatever it is and whether it is practical or not, satisfies me because I really love learning something new.

This may also be the reason why I started this blog.

Weird ECG

Take a look at the electrocardiogram (ECG) below. Maybe, you think that it is normal, but...

You would intuitively feel kind of weird with this ECG, wouldn't you? If so, I think youｒ feeling is right. You have a good sense of ECG interpretation.

Today, I showed this ECG to some young doctors, and none of them made the correct diagnosis although they appeared to think that it was not normal.

After I told them that it was an artificial ECG for the maintenance of a system, they were surprised but soon realized and accepted the answer.

I cannot explain well the reason why the ECG makes us feel uncomfortable but I am sure that it looks weird

A sphere

What in the world is this unusual object?

I found it at the station, where I changed my trains. When getting close to the round staff, I understood that it was made of wood. It seemed like that it was composed of lots of logs.

The panel under this object said that it is a work that was created by a Korean artist and that came to first in a competition held several years ago.

I like it because the concept of this artwork is exceptional. Each peace appears to be connected with each other, but any nail was not seen on the surface.

I am really curious about the way to connect wood logs in a shape of sphere. For me, this object looks like a puzzle rather than an art.

Code green

I am reading e-mails in my office at around 7 am, when a sudden announcement brakes the peace and quite atmosphere of the early morning.

It says, "Code green, code green, 4th floor." This is an emergency call in my hospital, meaning something that needs help with a lot of medical staff developed on the 4th floor.

I stop surfing the Internet and rush to the ward. I find someone undergoing cardiopulmonary resuscitation, and of course, immediately join to the support team.

After confirming the successful attempt and his recovery to normal vital signs, I come back to my desk. A monitor of my PC is showing the same as the page I was watching before I left.

I start to read my e-mails again, as if nothing happened.

This story may sound unrealistic but is not a fiction. It is my routine and I am used to such situations.

Fantastic scribbling

I found a sheet of A4 paper with pictures on the table in the living room.
I fell in love with it at first sight. No explanation is required, I believe.

No wonder, my 8-year-old son drew the 12 Minions. I guess he is also smiling at the right bottom corner.

They are really cute, aren't they?

PS
Later, my son insisted that the smiling face at the right bottom was not him but Mam, saying, "I love her very much."

Image formats

There are so many different kinds of image formats available. JPEG, GIF, and PNG are representatives on the Internet, although EPS or TIFF files are commonly required when submitting an article to medical journals.

Basically, every format is usable but I want you to know the differences between JPEG, GIF, and PNG. The knowledge will help you with creating your homepage. Let me share my understanding of these three formats with the readers of my blogs.

First, JPEG has a good balance of image quality and file size. Unless your image requires specific functions, the choice of JPEG will not go wrong.

Second, GIF is characteristic of movie, because one GIF file is able to contain more than one image inside. Movie GIFs, which have a function of animation, are recognized as a image file by computers.

Finally, PNG is useful in some situations because it has no background color. It means that a PNG file may be suitable to every website regardless of what color is used.

BGM

I usually listen to music while I am doing something with my PC.

My genre includes a lot of different kinds: rock, pop, classical, etc. Piano music is, however, best for me at work because it never affects my quality of work. Furthermore, it may boost or enhance my job.

I used to use CDs as a source of background music or BGM, but recently tons of sources are available online for free.

In this context, ABC Piano would be really good. I think that you would never regret it as long as classical music is your thing.

The problem is that my PC sometimes has a short freeze while this free content is working on background. It remains unclear if this small trouble is limited in my situation or could occur in other situations.

Water to eat

I drink water every day but I have never eaten water until today.

My son and I was hanging out at the mall in my neighborhood, where there were many people gathered in a small booth. The sign in front of the stand said, "Try to eat water. Amazing!"

The water put in a small balloon was on sale there. My son and I got it with curiosity and ate it together after removing the balloon.

The water was beautiful but actually had no taste; it was like a plain jelly without sugar. My son had only one tenth of the high-viscosity water and the rest was what I had to eat without chewing.

I think that the idea "EAT WATER" sounds fun but not practical because it cost two dollars per serving of about 50 ml.

Cardiac tomor

Cardiac tumors are a serious condition regardless of the pathological findings of the tumor, i.e., benign or malignant.

A practical diagnostic approach to cardiac diseases includes history taking, physical examinations, blood analysis, chest radiography, and electrocardiography. However, these techniques may not be useful in make a diagnosis of cardiac tumors. Needless to say, echocardiography is at the top of the list that should be considered among patients with cardiac tumors.

Let me show you an example.

I did not think that the patient would have a cardiac tumor until echocardiography was performed for sinus tachycardia. As the proverb goes, a picture is worth than a thousand words. Once in a while, the same goes with the field of medicine.

Echocardiography says, "Seeing is believing."

No hangover

I was wasted yesterday because I drank a lot, but I have no hangover right now.

Last night, my colleagues and I attended a scientific meeting, which is held twice a year, late fall and early summer. We had six speeches in the conference, with almost good results. Not to mention, we were content with our performance because hard work had been done for it.

After the meeting, we had a big meal at Izakaya or a casual restaurant. Wonderfully, the Izakaya was all we can eat and drink for three hours at a reasonable price, almost $40 per person.

After drinking tons of beer and Japanese sake, we moved to another barbecue restaurant and drank more. Nonetheless, I got up as usual and found myself without hangover.

Do you wanna know the secret?

I ate a rice ball in advance. Eating something small before start drinking is a good way for me to avoid having a hangover next day. It is simple but surely effective, I guess. Give it a try.

The sixth sence

I was tired that night, and went to bed at around 10:30 pm.
All of a sudden, something like a bleeze passed through my ears from the right to the left, when I have almost fallen asleep.

I got up and checked my cell phone, alarm clock, pillow and futon, but found nothing changed from before. Not to mention the windows or door in my bed room were closed. Suddenly, my patient, who has been in a serilusly critical condition and receiving palliative care, came to my mind for no specific reason.

A few minutes later, my phone rang, saying "Sorry to bother you, Doctor, but your patient's heart rate suddenly dropped." The patient died 10 minutes or something after the phone call.

I think that I am a scinentific person, and did not believe the sixth sence.
From now on, I may have to admit that there are many things that are scientifically unexplained.

Way to go!

The Circulation is the most influential journal in the field of cardiology. Publishing an article in Circulation could be a dream, although extremely tough, among cardiologists all over the world.

Today, I have got good news. Guess what? Our manuscript has been accepted for publication in Circulation. You may not believe it, but the first author of the article is a resident doctor, who graduated from medical collage just 5 years before. Congratulations!

The article is not a full-length research paper, but kind of a case report with impressive images. However, the value of the manuscript will not be reduced because the originality of her study is exceptional. Detailed physical examinations by this young, female doctor has made our dream come true. I am really proud of her and her work.

I would like to have a big dinner with her tonight. Of course, I will buy the dinner to her. Not to mention she absolutely deserves it. One sad thing is she is now in India for a vacation, and has not known this good news yet.

I hope that she is enjoying an offline life, sitting close to the Taj Mahal, a well-known white marble mausoleum.

Nuclear cardiology

Let me show you one medical image. What do you think it is?

This beautiful picture is what nuclear cardiology is like. Doctors can assess the presence or absence of myocardial ischemia as well as myocardial infarction if they are an expert in the filed of nuclear cardiology. On top of that, the extent and severity of myocardial damages, if any, can be assessed.

I would say, however, there are many cardiologists who are not good at this filed, although nuclear cardiology is very useful in making a decision among patients with known or suspected ischemic heart disease. Some fuzzy features exist on nuclear cardiology, which seems to make doctors stay away from this category.

Another problem is that it takes a while (e.g., 4 hours) and costs a lot (e.g., $700) to undergo nuclear cardiology.

Futon

I had not known that the word "futon" is an English word until I looked it up on my online dictionary.

The fact that Wikipedia has a page to explain futon in English surprised me.

A futon is a traditional blanket that is used in Japan when we sleep. It makes us feel warm and promises a comfortable night. I love a bedtime with a few layers of futons, especially in winter, because it is freezing cold in Japan. You may recommend that I can use a heater instead of futons, but I do not like using heaters while sleeping. All night heaters sometimes make me feel uncomfortable in the throat when I get up.

I tried wearing a mask with heaters, but no improvement was obtained because I felt I could not breathe well during sleep. Such a kind of problem can occur when I stay at a hotel.

Heart sound and position

Heart sounds vary depending on where a stethoscope is placed.

Let say, if you put a stethoscope on the apex of the heart, the first sound (S1) is louder than the second heart sound (S2). On the other hand, S1 becomes smaller than S2 when the stethoscoep is moved to the basal part of the heart.

Easier to hear than to read. Click musical notes below and get it.

Apical heart sound:  ♪♪♪
Basal heart sound:  ♪♪♪

This rule is simple and easy to master, but surprisingly, many doctors ― even some cardiologists ― know next to nothing about the balance between S1 and S2. To be more precise, they had learned at medical callage, but has forgotten it.

Kujibiki

Kujibiki is a kind of lottery and very popular among kids in Japan.

The rule is very simple. First, you pay a small amount of money, such as one dollar. Second, you pick up one piece of folded paper in a box where there are many pieces of folded paper. Third, you open the paper and check the number written on it. Finally, you can get a gift according to the number that you got.The numbers are usually form one to one hundred; the smaller the number, the better the present.

The left picture is what my daughter got on Kujibiki at a local festival yesterday. Her number was two although her little brother got almost No. 100. What she got, a bag of one of Disney characters, has been attracting her recently. I was very happy to see my daughter excited.

When it comes to Kujibiki, I think that she is always lucky, as is her mother. It seems like good lucks run in the women of my familiy. That means I am lucky as well, because I am always close to them.

Old coins

When I was a kid, what I really loved was to collect old Japanese coins. But I have forgotten it for a long time.

The other day, my younger son found a small, wooden box in the storage. He came to me and asked, "Daddy, what's that? Can I open the box?"

The first glance of the old box reminded me of my old hobby (i.e., coin collection). This box was my treasure. I opened the box, checked many coins, and closed the box － that was my routine at that time.

My son and I opened the box for the first time in decades. What surprised me was I still love old coins. They varied in terms of shapes and materials; a round or square shape: silver, copper, or gold: small or big ones.

Unexpectedly, my son was not interested in these old coins. This may be because he cannot get candies with the old coins.

JS Bach

I cannot get enough of music composed by JS Bach.
Actually, listening to Bach, I am writing this blog right now.

Bach made a wide range of classical music, from piano to violine. Among them, piano works are what I have been attracted most.

Bach is a really great composer as well as an educator. However, Bach may remain you that you had been forced to play his piano music, such as the Inventions and Symphonias, to improve your piano skills as a child. That made some people dislike him, I geuss. It would take a while to understand the value of Bach; I found myself fascinated by Bach after I turned thirty.

The Goldverg vriations are one of my favorite music written by Bach. This wonderful piano piece starts with a lovely small aria, followed by a set of 30 variations, and ends with the peaceful aria again. The exceptional creativity based on mathematical methods is beyond my imaginations.

If you give it a try, I recommend the Gordlberg variations played by Glenn Gould. The eccentric Caniadian pianist recorded this piano piece twice, in 1956 and 1981, and both are excellent.

My dream is that the Goldberg Variations played by me is released during my golden years.

Color Doppler

Non-medical people would think that echocardiographic images are always black and white, but it is not true. Please take a look at a video below.

The right panel shows the same image as the left panel with color data. You can see blue and red flows by color Doppler. These colorful signals are not bloodstream themselves but reflect the direction of blood flows in the heart.

Red signals indicate blood flow toward the echocardiographic probe, which is located at the top of an image. On the other hand, blood flow away from the probe is shown in blue. This rule of the color mapping on echocardiography is universal.

Who discovered this color Doppler technique? The answer is two Japanese guys, an expert engineer and a cardiac surgeon (Omoto R, Yokote Y, et al. Jpn Heart J. 1984;25:325-40).

I am very proud of the discovery by the Japanese, but few know about it even if they are Japanese medical staff in the filed of cardiology.

Great Wall

I have been to Great Wall of China when I was in college.
It moved me because the Great Wall was too long to imagine how long it would be.

The Great Wall is located in the northern part of China and, no doubt, the longest structure in the world. It is said that the length is more than 7000 km, which is longer than the Japanese archipelago. Wonderful. I cannnot imagine how long it took to create.

I have heard that the Great Wall is the only human-made construction that can be seen in the universe. I thought it would make sense because it is incredibly humongous. However, a podcast I listened to the other day said that it is a common myth. Actually, it seems like nobody can see the Great Wall from outer space.

I am still wondering if it is true or false.

I am looking forward to receiving the answer from an astronaut who happens to read my blog in the International Space Station or ISS.

A canned coffee

I do not think I am a coffee person, though I drink several cups of coffee every day at work.

Studies show that drinking coffee is associated with a longer life. Maybe coffee is effective in reducing stress. Green tea seems to have the same benefits. In addition to such a relaxing effect, to avoid getting dehydrated is likely to be affecting favorably in terms of life expectancy.

There are so many vending machines in Japan, and you can get cold or hot beverages, such as coffee and green tea, at a reasonable price (almost 1 dollar). It is very convenient but I seldom get something to drink from vending machines during work. I take advantage of free drinks provided at my office. This is not only for saving money but also for saving energy.

Although vending machines used to be a high energy consumer, the electric bill of a vending machine is currently reported to be a quarter as much as 10 years. This technological advances, however, do not justify a waste of electricity. Japan, where I was born and raised, is a really small country with little natural resources.

This canned coffee, as shown above, is a small gift for me since I have done a good job at work.

" "

Can you see the title of my blog? I guess you cannnot.
Today's tilte is "&nbsp;" not but only quotation marks.

I did write "&nbsp;" on the title but it never appears.
I really hate " &nbsp;".

You may think that "&nbsp;" is a typo or funny characters related to fonts, but that's not true. This is a code used on a computer language (hyper text markup language, HTML), and means adding one space in a text.

Let me show an example.
Sample A: "I am the best blogger."
Sample B: "I&nbsp;am&nbsp;the&nbsp;best&nbsp;blogger."

Joking aside, both of the samples A and B have the same meaning on HTML. I am sure the former looks more natural than the latter. However, it does not seem to matter to computers. They have no feeling (so far), and never mind things like that as long as codes are written correctly according to the rule of HTML. Do you like the way that computers like, just like rule is everything?

The "nbsp" stands for Non-Breaking SPace. To be honest, I did not know that, but Google taught me as usual.

We have to keep in mind, Google website is also working on this HTML rule.

A heart sound

Have you ever heard of heart sounds?
I am not talking about the voice of the heart but sounds that the heart makes physically.

Here is a normal heart sound. ♪♪♪ (click to hear)

I recommend that you listen to the sound with earphones jammed in tight. PC Speakers would not work well in terms of the reality. Sorry about the back ground noise but this is a real heart sound that doctors listen to with a stethoscope in dairy clinical practice.

Heart sounds are basically composed of two elements, the first and second sound. If your heart sounds have more components other than the first and second sound, you should go see your physician because an additional heart sound may be associated with heart problems.

Interestingly, the third heart sound is common among healthy children and adolescents, called "physiological third sound". The third sound disappears in their twenties and can appear later when you suffer from heart diseases, for example heart failure.

Benz and BM

Here is a short dialogue between Taro and John.
Taro is an English learner and John is his English teacher.

Taro: "I'm really into cars."
John: "I love automobiles, as well."
Taro: "Auto...? Anyway, I have a Benz and a BM."
John: "Oh, you have a Mercedes and Beemer."
Taro: "Mer...Bee...? English is difficult."

There are many automakers in Japan. Google says more than 25: Toyota, Honda, Mazda, Nissan, Subaru, Mitsubishi, Suzuki, Hino, Isuzu, Daihatsu, Fuso, UD Trucks, Mitsuoka, ElecTrike Japan, Dome, Takeoka, etc.

I am wondering if these Japanese automakers are also called differently outside of Japan.

Valsalva aneurysm

An aneurysm of the sinus of Valsalva is a rare condition defined as a dilation between the aortic valve and the sinotubular junction.

This disease used to be diagnosed after the rupture of an aneurysm, but recently, unruptured aneurysms of the sinus of Valsalva appear to be detected incidentally by imaging modalities.

Below is three-dimensional CT images of an unruptured Valsalva aneurysm.  You can see a sack-like structure attached to the right coronary cusp; three arteries are the right coronary artery, the left anterior descending artery, and the left circumflex artery.

Surgical repair is recommended for a ruptured Valsalva aneurysm, but the optimal treatment remains unclear among asymptomatic patients with an unruptured aneurysm.

Surprisingly, most of Valsalva aneurysms are congenital although some are acquired, e.g., trauma or infection. It would take several decades for a tiny pouch to glow up.

Patient's words

Here is a dialogue between a doctor and patient.

Patient says, "Recently, I've had chest discomfort, doctor."
Doctor asks, "I see. When does it happen?"
Patient answers, "It occurs while jogging or walking briskly, but not watching TV."
Doctor says, "I'd like to take an electrocardiogram to check your heart."

Several minutes later...

Patient asks, "How was the result, doctor? Is there something bad?"
Doctor replys, "The electrocardiogram is completely normal."
Patient says, "What a relief! I thought I might have heart problems."
Doctor adds, " Don't worry too much about it."

Do you think this doctor has the ability to make a diagnosis among patients who have chest symptoms?

Of course not!

In the management of angina or ischemic heart disease, normal findings on electrocardiography, echocardiography, chest radiograph, and blood examinations do not always guarantee health. I believe what we should pay attention to is to take a careful medical history.

Sir William Osler, one of the best-known physicians, said, "Listen to your patient, he is telling you the diagnosis."

A blend word

"It's fantabulous! Really humongous," said Mr. A.

It goes without saying that fantabulous means fantastic and fabulous, and humongous is huge and monstrous. These blend words are effective in enhancing what you are talking about, such as the size or wonderfulness. The rhythmical sounds of these words are another reason why blend words are quite popular especially among teenagers.

Have you ever heard of "KIMO-KAWA"? It is a blend word in Japanese. I have never heard of it before, but young girls are likely to use this slang word. It is a combination of "Kimochiwarui" or creepy in English and "Kawaii" or cute. Then, "KIMO-KAWA" refers to something creepy and cute.

Does my explanation make any sence?
Can you imagine anything creepy but cute? I am wondering what in the world it is.

I asked Google - Here's the answer.

Heart rate

How would you react if you knew that your heart beats are a countdown to death?

Basically, the number of heart beats in the life span of each animal is almost determined. The upper limit is estimated to be about 1.5 billion times per life in most animals. Mice have an average heart rate of 600 beats per minute and a life span of 5 years or shorter, whereas elephant's heart rate is 20-30 beats per minutes at rest and their life spans are as long as 50-80 years.

The same rule is also applied to human beings, although the total count of heart beats can double probably because of clinical medicine and public health. There is statistical evidence showing that those who have a lower heart rate can live longer than those who have a higher heart rate.

The point is that a life span might be expected on the basis of heart rates, to some extent.

Of course, aside from a heart rate, there are many determinants of life span, such as comorbidities, geographic location, gender, socioeconomic status. However, if you have a higher heart rate at rest, e.g., 100 beats per minute or more, you might as well go and see a physician. Something unfavorable may be hidden regardless of whether you are symptomatic or not.

Do not worry too much if your kids have a higher heart rate. Children's hearts are always beating with a lot of energy.

Rosso corsa

Ferrari, an Italian sport car, goes well with rosso corsa, which means racing red in Italian. It is said that rosso corsa is the national racing color of Italy. So many guys like Ferrari painted rosso corsa, so do I, although not affordable.

You can see a red panel below. How do you feel about this color?

You would say it is a tinge of red, compared with rosso corsa. Believe it or not, this is a photo of the wall of my house. Don't you think it looks weird? Have you ever seen such a fun-colored house?

My wife and I had the house built several years ago. The house was supposed to be painted beige but our choice was not available for some reason. We decided to paint the wall red, which had nothing to do with rosso corsa.

My wife was frightened to initially see the house painted red and called me at work, because the color had a stronger impact than she expected. In order to check it, I left my office and rushed to our house under construction. What I told to my wife was "what a beautiful color it is.", making her feel relieved, she said later.

To be honest, I was also a little shocked to see the vivid color but I pretended I liked it at that time.
It was not long we got used to the color. Now I can assure you that it always relaxes me.

Angina

I am wondering if most people are familiar with a word, angina or angina pectoris.

Angina is a medical condition associated with myocardial ischemia, and commonly develops on exercise but can occur even at rest. During an attack of angina, you feel discomfort in the chest.

Most people, including medical staff, consider chest pain a typical symptom in patients with angina, but it is likely to be a stereotypical misunderstanding. According to my patients who are diagnosed with angina in my hospital, the symptom is different form chest pain. They say it is not painful but oppressive; it could be expressed as a toothache or headache in some cases. Remember, symptoms associated with angina vary depending on the patient.

My recommendation is that you do not have to make a diagnosis. Given the relatively high mortality of patients with angina who are not appropriately treated, you should consult a cardiologist, especially if you have some risk factors, such as diabetes, hypertension, dislipidemia, smoking, and a family history of heart disease.

If symptoms last 15 minutes or longer, special attention should be paid because it may suggest more unstable conditions, such as myocardial infarction. You have to visit the emergency department as soon as possible.

Let's gather cats

Are you a dog person or a cat person?

 

There are distinctive differences in characteristics between dogs and cats, although both are very popular as a pet here in Japan. In general, cats are thought to be more standoffish whereas dogs are likely to be more loyal.

I thought I was more of a dog person, but my mind has changed since I came across an app called Neko Atsume, which was developed in Japan and means "Let's gather cats" in English.

 

The rule of the game is very simple. You put food in your garden and then see cats gathering to eat the food. One interesting aspect is that the characteristics of cats are different each other. As you can see below, a white fat cat is sleeping peacefully after eating a big meal, a brown one is playing with the body hiding in a bucket, one having a bat seems to be a baseball fan.

 

 

Actually you cannot touch or catch them. Cats come on a whim when there is food and leave without saying anything when getting tired. Taking a picture of them and keeping the photos in your cat album is only allowed in this game. Nevertheless, this app has been fascinating to me for months. Also you may be, more or less, addicted to their cuteness.

From now on, I won't say I am a dog person.

Also you wouldn't even though you prefer dogs to cats.

No underpants

Last night, after taking a bath, I found no underpants in the dressing room. I usually put a pair of pajamas and underwears on the shelf before bathing, but I was likely to forget to bring my underpants. All of my clothes are upstairs, so I decided not to wear it.

Some women appear to have a habit of wearing no bra and panties on the bed, but it is not common among men. I am an averaged person and I have never slept without underpants before last night. I was worried I would catch a cold but nothing bothered me at all.

Sleeping with no underwear may have a few advantages.

• Can save money to buy underpants.
• Can save time to go to clothes shops.
• Can save water to do the laundry.

I am not going to encourage you to give it a try because possible contribution, if any, is a bit. However, no-pnats-sleep may be invaluable in a certain situation. For example, it would work well in August in Japan because it is boiling hot and disgustingly humid.

At last I have to say that wearing no underpants was very handy when I went to the rest room. Concerns about poor sanitation were raised, though.

Heart in the heart

Here is a simple question.
Can you see anything unusual and funny on the chest radiograph?

There is an inverted love mark in the cardiac silhouette.
So, you would say, "Heart in the heart!"

A diagnosis of esophageal hiatal hernia was confirmed by computed tomography and gastroscopy. The upside down heart in the present case was likely to be created by the trapping air in the stomach protruding into the chest cavity through the opening of the diaphragm.

The patient has been doing well for almost three years with antacids.

Star Wars

I guess that everyone has heard of "Star Wars", a sci-fi movie. I am a big fan of sci-fi movies and happy to know that a new series of Star Wars, Episode VII The Force Awakens, is coming this December.

My daughter and I enjoyed watching Star Wars Episode I, II, and III last weekend. Unexpectedly, the Episode III that I got was not dubbed into Japanese; only English and Chinese subtitles were available. I wanted to use English subtitles so that I could understand the story more, but my 12-year-old daughter declined it because it might disturb the beautiful computer generated images (CGI). Another likely reason is that she was unable to read English. I had no choice but to watch the movie only with English voices.

This is my first time to watch English movies without subtitles, but I was able to follow the story more than I would expected. It is unclear how well my daughter caught the story, but I am 100% sure that she had a lot of fun with the movie because the CGI effects were exceptional.

While watching these three series of Star Wars, I have realized that the CGIs looked more fantastic in Episode III than in Episode I or II. This is because no subtitle in Episode III enabled me to focus more on the CGIs, I think.

I have to say, "Thank you, my daughter." Her request (i.e., no subtitle) reminded me of a real attractiveness of sci-fi movies.

A raw egg

I thought that what non-Japanese people really hate to eat was Natto or fermented soy beans. However, I have recently recognized my misunderstanding. It is likely to be impossible for them to try a raw egg although we Japanese often enjoy having dishes with a raw egg, such as Sukiyaki, Beef bowl, and Udon noodle. Among them, Tamago Gake Gohan, as shown below, is my best because of the balance between the taste and simpleness.

I often eat Tamago Gake Gohan for breakfast and cannot get enough of it. Let me explain how to cook this wonderful dish. All you have to do is to put a raw egg and pour soy source over hot rice. That's it. Stirring them before eating would make the taste more yummy.

The other day, a famous American educator, who has live in Japan for more than 30 years, said on the radio that she really hated rice with a raw egg but not natto. That made me really disappointed.

Let me give you some tips if you give it a try. First, use a fresh egg, or you will suffer from abdominal pains, diarrhea, and vomiting. Micro organisms could grow, such as Salmonella, especially in summer or a rainy season. Second, do not take a while to cook, or the egg will go bad. You should know that micro organisms love room temperature.

Finally, more importnat, do not try to eat if you feel disgusting when you take a look at the picture above. It is quite rare to look unappetizing but taste good. People get more information from their eyes than from the taste buds while eating.

Maybe everything is under the control of the brain.

Ventricular fibrillation

Here is quite a rare electrocardiogram (ECG). The point is that it is not a monitor recording but a standard 12-lead ECG.

This is one of the most scary arrhythmias, called ventricular fibrillation. Death would be unavoidable, unless the arrhythmia ceased spontaneously in a few minutes. To save a patient with ventricular fibrillation, cardiac resuscitation, followed by electrical defibrillation, is required as soon as possible.

Given that it takes dozens of seconds to record a standard 12-lead ECG, the present ECG is no doubt extremely uncommon. I would say that you have never seen an ECG like this, even though you are an experienced cardiologist. Actually, this is my first time during about 20 years of clinical experience as a cardiologist.

I quote this ECG from my website, where more than 300 ECGs with a simple explanation are available free of charge. While I was uploading an ECG of ventricular fibrillation, my little child, kindergartener at that time, mumbled anxiously, "Oh my goodness...he's dead." Of course, he has never learned about ECG.

Ventricular fibrillation seems to be so striking that even kids cannot help feeling something ominous.

Creeper

Minecraft is a popular online game released in 2009. I do not know much about Minecraft, but my two sons are really into it. In Minecraft, you are likely to be in a world of blocks. Everything is made of various kinds of blocks, such as metal, wood, soil, or ice. You can create whatever you want to make with these blocks. So many fantastic works on YouTube may frighten you because they are beyond the limitation of your imagination.

Creeper is an enemy that you fight against in Minecraft. Literally, Creeper seems to be made up of plants, watches and follows you eerily, and, once in a while, explodes. You may be injured or killed.

Last weekend, my younger son, who is in second grade at elementary school and a big fan of Minecraft, asked me to create Creeper. Surprisingly, he was already planing to use cardboard boxes as the frame work and folding papers for the pixelated appearance.

The process was way much tougher than I expected, but my son did make it with my support. Actually, it took two or three hours but he continued to work with fun. I respect his approach and endurance.

A fun-loving attitude and never-give-up spirit are what I really want my kids to have.

The heart

Have you ever seen your heart? I guess that you would say "Of course not." Believe it or not, I have!

To be honest, it is almost impossible to directly see your own heart with your naked eye. Such situations, if ever, would lead to your death in a minute. An indirect way to see your heart, however, is available. Medical institutions have a variety of devises that make it possible to depict the heart, for example echocardiography, computed tomography, and magnetic resonance imaging.

Among these medical modalities, echocardiography is the most recommended. All you have to do is that you put an ultrasonographic probe on the chest after lifting up your shirt. It is very convenient and handy, isn't it?. Another advantage of echocardiography is no need for radiation exposure. In my hospital, I usually show my patients a movie of their heart, as shown below.

 

My small gift always surprises my patients. It seems like that they are impressed and satisfied to see his or her heart beating dynamically and continuously. They say, "Oh, this is my heart? Awesome! Thank you, doctor. You are so nice." Also, their words make me feel good and motivate me to work more heartily.

P.S.
Some may care about the cost to examine the heart by echocardiography. Luckily, it is affordable in Japan: almost 10 to 30 dollars on health insurance. I have heard that it would cost too much in the U.S., at least 10 times higher than in Japan, to undergo echocardiography, although it seems to vary depending on a hospital where you are examined.

Ramen

Yesterday, I was craving Ramen. So, after work and on my way home, my wife and I went to a well-known Ramen restaurant. We were surprised to see dozens of people standing and waiting in line for the Ramen but it never discouraged us. Ramen is terrific for me.

 

Ramen is a Japanese word. It is a kind of noodles. I guess that it originated in China and was developed in Japan. Ramen is quite popular regardless of age and gender in Japan.

Ramen consists of three essential elements: noodles, soup, and toppings. These are generally served together in a single bowl, as shown in the picture - I took that yesterday.

In my opinion, the quality of Ramen is assessed by the combination of the three essential elements. The taste would be be undistinguished if each ingredient is excellent but the combination is awful.

Of course, we should remember that there is no accounting for tastes. Actually, between me and my wife, there were differences in rating of the Ramen we ate yesterday. There is no definite way to estimate Ramen. It is not book reviews or Internet ranking that counts. The point is, the best Ramen for you is one that you think the taste is No.1.

Medical article

Here are two sample sentences. Which is your preference?

Sample A
An increased body wight was associated with an increased risk for developing cardiovascular disease in patients with diabetes.

Sample B
Obese people with high blood glucose had heart disease more frequently.

The answer may be different on a situation to situation basis. Basically, these two sentences have the same meaning, but sound differently. I was taught to make a sentence like Sample A but not Sample B when I write a medical article. I believe that the same goes with almost all fields of science.

Some might insist that Sample A is more accurate than Sample B, although Sample B is easier to figure out in practice. I used to think so, but recently, I have been wondering whether the difference between Samples A and B should be considered academically significant.

I believe that articles in the New England Journal of Medicine, which is the top journal in clinical medicine, can be a good role model on how to write scientific articles. According to my experience of the journal for more that 15 years, the trend seems to favor Sample B, although most sentences are still in an area of Sample A.

Simple is best. This is what my mentor told me when writing manuscripts. In my opinion, academics tend to like using difficult words to understand in addition to jargon. I would not be happy if I were such a person. So, I have to keep this golden rule in mind: the easier it is, the more it works.

Favicon

It was just last month when I heard of the word "favicon." My response was "what in the world is it?"

A favicon is an iconic symbol referring to a website. Let me show you a round-shaped, red fish as below. I made it by myself. It was vary easy to create, taking 10 minutes or less.

 

You can find the same image at the top of your screen (not in the right-side bar). As you guess, small images on the tabs of browsers are called favicons. I would say that a favicon is very useful in encouraging you to visit the website again. I am going to omit the detailed explanation because more informative websites than my explanation are available, e.g., Wikipedia.

My colleague told me that my blog's favicon was fantabulous and no doubt better than Google's favicon that has been recently released.

All I wish is that the word of favicon is getting more and more popular since it may be too cute to miss. From now on, you can pay more attention on a favicon.

Operation

I am a doctor, cardiologist, and often perform operation, such as angioplasty or pacemaker implantation, for patients with heart disease. Operation is going to be today's topic on my blog, but it is not associated with my career. Today is the day for my mother to be scheduled to undergo orthopedic surgery.

My mom was a very active person. She enjoyed swimming over 1,000 m almost every day, but recently prefers indoor activities because of pain in the legs. A diagnosis of lumbar canal stenosis was made in the hospital where my big brother works. She told me that she has tried some alternative treatments, e.g., herbal medicine or acupuncture, with little improvement

I am not sure that I am familiar with the field of orthopedics, but I have no worries because my mother's surgeon is a close friend of my brother and an experienced orthopedist. What a relief! Complications cannot be completely avoided when it comes to surgery, but I believe that her operative course is uneventful.

In general, people think that a successful operation can be confirmed at the end of surgery. However, I disagree with this concept. Whether operation is completed successfully or not depends on the operation itself as well as the postoperative course. There are some serious complications that could develop days later. Make sure that patients and their relatives have to wait and see until the patient is discharged from the hospital in a stable condition.

I am looking forward to the moment though doctors including me are not patient.

HTML

Have you ever heard of the word of "HTML"? If you are already familiar with HTML, I recommend that you spend your time more productively instead of reading today's my blog. Just to let you know, HTML stands for hyper text markup language, and is a basic language that is used for creating websites. Sample HTML descriptions, partially quoted from Yahoo.com, are below. 

<div class="bg-container">
   <button class="intl-selectorfull" aria-haspopup="true"> 
      <span class="ti pos-a">Select Country Site</span> 
   </button>
</div>

Some two years ago, I was determined to create a web content regarding electrocardiography (ECG) for less-experienced medical staff, but I had next to nothing about how to write a computer program or HTML. Looking back, I used to handle simple codes as a high school student, but my skills as a software engineer, if any, were not associated with HTML, and all of them has already evaporated from my head.

My idea about an ECG website was proposed to our hospital but unfortunately, and as anticipated, has been denied due to lack of a budget. It would cost a few million yen or 20,000 to 30,000 dollars to have a program made by outsourcing. Almost sounds like that I had no other way but to give up my idea. Of course, I had no intention of surrendering!

To make my ideas into a reality, I started to learn HTML by myself. Luckily, a bunch of information on the Internet enabled me to become a self-taught software engineer. Now I am able to write standard source codes, although it is still difficult to make complicated, sophisticated ones without any help. I would say that the barrier of HTML is not as undefeatable as you think that it would be. You can do it as long as you keep on HTML.

Electrocardiography

I am a cardiologist and quite used to reading an electrocardiogram or ECG. Actually, I have been in charge of teaching ECG to young doctors in our hospital for more than 15 years. Believe it or not, however, it is true that cardiologists do not always have a good ability to interpret ECGs. I thought that I had had a good knowledge regarding ECGs, but I have realized during the process of ECG education that my expertise was not competent. Let me make sure that the world of ECG is so deep that mastering ECG is quite a challenge even to an experienced cardiologist. No wonder I am still learning.

In my hospital, an ECG conference is held every Wednesday and I have managed to operate the meeting. One day, a young doctor in his twenties told me that the conference was informative but not so convenient due to the time schedule. He complained that there were a lot of things on his plate on Wednesdays. This made me decide to create a website where you can learn ECG anytime and anywhere. If you are interested in the field of ECG, why don't you click here? No charge is required!

Software engineer

I am curious about the situation of being a software engineer, whose job is simple, e.g., just to write a program, but very important because modern devices such as iPad and iPhone would not work well without appropriate software. It seems like that competent programmers have been short-handed and they would be in more and more demand in the future. In this context, it is no wonder that Millennial generation is expected to be good candidates for talented programmers since they are "natural internet users." They were born in the situation of which the Internet has been available. Surprisingly, my 8-year-old son is capable of handling with my iPad and Internet surfing without any help.

If you are interested in the field of software engineering, I encourage you to listen to a Podcast "Rebuild" by Tatsuhiko Miyagawa, who is a Japanese programmer and has lived in San Francisco for about 10 years. You can enjoy his chats with his colleagues about tech, software development, gadgets, and, once in a while, Japanese anime. Maybe the Japanese are limited with his Podcast because they speak only in Japanese on the Rebuild. Those who are fluent in Japanese language may have fun with this Podcast, but I have to confess that some parts of the Podcast are still difficult for me, a native Japanese speaker, to understand because of a bunch of technical terms and Internet slang words. It has, however, never ceased to fascinate me. Good luck with Rebuild and Mr. Miyagawa.

First submission

I decided to start my blog, with no specific reason, just 20 minutes before, when I was eating breakfast with my family as usual on weekends. The title of my blog "A school of fish swimming under thistles" comes from the phrase that I read on the newspaper a few days ago. I have never heard of this sentence; it may be a well-known proverb originating from ancient China. It basically means that we should not live only for ourselves but try to contribute to the society that we are all part of. I was in a stressful situation with my daily work at that time, but getting to feel well after I came across this phrase. Since then, I always try to remember it to control my emotions.

The goal of my blog remains unclear, but it would be cool if I would be impressed when looking back my first submission years later.