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 " " not but only quotation marks.

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

You may think that " " 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 am the best 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.