All you can eat buffet

The other day, at my children's request, my family of 5 went to a unique restaurant where you can eat as much as you want to eat at the same price.

The shop serves a variety of foods, including grilled meat, sushi, curry and rice, noodles, desserts, you name it. The entry fee is affordable, 13 dollars per adult and 10 dollars per child for about 100 minutes.

It is common that the quality of food at such restaurants is not as good as those in standard ones, but it is not true with the all-you-can-eat buffet that we had lunch.

We had a fun time there, but the problem is the amount that my family has eaten. Judging based on the plates piling on the table after eating, our portions were way much small than other people. This is because, among 5 members, 4 except for me are really small eaters.

It seems like that our 3 kids like such a fun atmosphere at an all-you-can-eat restaurant, instead of trying to eat economically.

Paradoxic flow

Take a look at an echocardiogram on the left. What is your impression?

This color-M mode image was obtained with a Doppler cursor in the mid-ventricle in a patient with mid-obstructive hypertrophic cardiomyopathy.

As you may know if you are a sonographer, a flow in the left ventricular cavity moves toward the apex during early diastole due to an apical suction.

In this case, however, the opposite phenomenon is shown; note a blue signal (white arrow), which is a blood flow from the apex toward the base of the left ventricle during early diastole or isovolumic relaxation time.

This situation is called diastolic paradoxic jet flow. This unique echocardiographic finding indicates the presence of a high-pressure apical chamber and has been reported to be associated with adverse outcomes.

For more information, you can access here.

On the radio

I made a radio debut with a big success!

I talked about the current understanding of cardiac rehabilitation on a live radio show. The radio broadcast is local, not nationwide, but I am very honored to have such a lucky opportunity.

I get stage fright easily, but I did not become nervous at all although it was my first time that I talked something on the radio or TV. Truth be told, when I received the offer, I thought I would be stressed out on the radio.

My success may be due to a good support with a well-experienced female anchor. No wonder she has fantastic skills with her beautiful voice to make guests feel easy in the studio. I cannot thank her.

On top of that, her multitasking abilities really surprised me. She was actually busy not only helping me but also organizing the time table.

I got a audio file of the 15-minute talks between a pro anchor and an amateur doctor. My family's reaction to the recording was, unexpectedly, not bad. My three children, who are likely to be indifferent to such stuff, kept on listening to the whole file, not complaining but sometimes laughing.

J league

The J. League or Japan Professional Football League has started a new season.

Today, my younger son and I went to a football stadium in my residential area to watch one of the opening games, as shown in the left picture.

This is my first time that I went to the stadium, which was just built a few months ago as a new home ground of Gamga Osaka. I am a fan of the team.

I have found the brand new stadium audience-friendly, as compared with the old one. We could see the players more closely. I could hear as if they breathing roughly next to me.

My son and I really got excited by the match, although our team Gamba Osaka has lost.

Fragmented QRS

Take a look at an ECG on the left and give me your diagnosis.

Note small notches in both lead V1 and lead V2, findings suggestive of tiny myocardial fibrosis in the area reflecting the leads or the anteroseptal wall.

You may make a diagnosis of fragmented QRS, which is defined as 2 or more notches in consecutive leads of the same group (i.e., inferior leads, lateral leads, or leads V1-4). Attention must be paid on ECG with bundle branch blocks, though.

The clinical significance of fragmented QRS remains unestablished but there are some reports to show that fragmented QRS is significantly associated with an increased risk of cardiovascular adverse events in the future.

We did it

As you may know, tons of people were surprised to see news last week, which said "We did it. At last, we've got an evidence of gravitational waves." No wonder, it is an historical moment in the filed of science and I was so happy to be with the moment (I am not a member of the research team, though).

Yesterday, my colleagues and I said at around noon, "We did it. At last we've got an evidence!"

What we succeeded in detecting is a new heart murmur associated with a paradoxical jet flow from the apex to the base of the left ventricular during early diastole. This unique flow was found by my senior colleague about 30 years ago, and has been well known among experienced sonographers all over the world.

To our knowledge, this is a first case in which a diastolic murmur was confirmed in relation to a paradoxical jet flow. We have to write a report regarding this fantastic heart sound as soon as possible.

Entrance examination

Today, my son may be a little bit feeling nervous although he looked like the same, for me, in the morning.

This is my first time that one of my kids has entrance exams. My elder son attends local junior high school now and will start a high school life this spring or April. As you may know, a new school year starts in April in Japan.

I hope that he passes the exams because he deserves it; he has studied pretty hard for more than a year. I was impressed to see that my son did not stop studying even during new years holidays.

All I can do is to encourage and support him, given his superiority to me in terms of school subjects.

I am always keeping my fingers crossed for our children. Good luck on my proud son!

Let's do CPX!

It has been almost a month since I posted my last blog.

So I have to say, "Long time no see. How have you been doing?" Me? I've been doing well. Thanks for asking.

Today, I have good news. The website that I have been spending tons of hours creating has been finally completed, where you can learn about cardiopulmonary exercise testing or CPX for free.

http://phio.panasonic.co.jp/kinen/cpx/index.html

Feel free to contact me if there are any comments or suggestions. The possible problem is that you need knowledge of Japanese language in order to understand the website because the content is written almost only in Japanese. Sorry about that.

Duel masters

Today, my younger son came to me with a blue box made of metal. He looked happy.

He open it and asked me, "Dad, you know it. Tell me how to play." I saw a lot of cards in the box and immediately understand what they were. The many different kinds of cool, paper cards were Duel masters, which had been popular among teenagers a few years ago.

It seems like that he found it in the closet of his older brother's room. The cards remained me of our old days, when my older son and I played them every day.

I have almost forgot the rule of Duel masters, so had to watch YouTube to remember it. What surprised me is that my younger son also watched the YouTube next to me, and understood the rule of Duel masters as good as what I understood.

Thereafter, as you guess, we spent hours playing the cards.

Happy new year

As usual, I woke up before 5 am, got on a train, and arrived at my hospital.

Today, I was a duty doctor and spent more than 8 hours in the hospital. You may think I was not happy, but I have to insist that it is not true.

Actually, I did not have Osechi, which we Japanese usually eat with their family in the morning on new year's day, but I enjoyed it with my family members for dinner.

The Osechi that my wife cooked for us was so delicious. I have always admired her because she is a really good cook, wife, as well as mother. On top of that, she never complains no matter how busy she is.