Greetings from Osaka!

By James Thomas posted 04-28-2016 09:59


27th JSE and 4th AAE Annual Scientific Sessions

James D. Thomas, MD, FASE


Thursday, April 21, 2016:  Greetings, ASE, from the land of the rising sun.  ASE Vice President Vera Rigolin and I are here representing ASE for a joint scientific sessions of the Japanese Society of Echocardiography (JSE, their 27th) and the Asia-Pacific Association of Echocardiography (AAE, their 4th). As always (in the words of Jimmy Martin), “it’s a long way from here to over yonder”, in my case a 4AM wake-up call for a 7AM flight to San Francisco followed by a 12 hour flight to Osaka, my first on the Dreamliner (love the electroluminescent window shades!). 

After an hour drive from Kansai Airport to the Rihga Royal Hotel, there’s just enough time to shower and change into my suit before the bus leaves for the JSE Faculty Banquet in the Garden Oriental Restaurant in the middle of a beautiful park in the center of Osaka along the river.  It doesn’t serve Japanese cuisine, more continental with a few Japanese notes (how about seared fatty tuna sashimi served with a soft boiled egg and French caviar?).  Conference chairman Satoshi Nakatani welcomed us for the evening.  Satoshi was a research fellow of mine from 1993-5 and is now President of the Japanese Society of Echocardiography.  It’s truly gratifying to see my old fellows doing so well in their careers.  We then turned to the serious task of breaking open a giant drum of sake.  I was called up, along with EACVI President Gilbert Habib and AAE President Jae Oh. With one swing of our wooden mallets, the sake was free for consumption.  It was about this time that Vera arrived, straight from the airport and looking fabulous thanks to a lightning shower and change of clothes in the JAL lounge in Tokyo; she truly earned the hearty traveler award for the day!  She offered greetings and a toast from the ASE.  After a few more minutes for mingling with old fellows and friends, it was time for dinner, a wonderful seven course delight. The evening ended with a somewhat surreal operatic interlude involving a pianist and an outstanding tenor singer.  It started with a standard issue aria but then transitioned to an ode to a Japanese snack (white bread with bean jam and mayonnaise) and a salute to Space Cruiser Yamato, a Japanese cartoon space ship. Finally it was time to rest!


Friday, April 22, 2016:  Today we got down to the serious business of educating the Japanese echocardiography community on the latest updates in our field.  Both Vera and I had 50-minute keynote addresses presented to several hundred attendees.  My talk was on myocardial strain, concentrating on clinical applications, future directions, and the important work that the Task Force on Strain Standardization has done to minimize the impact of intervendor differences in strain measurements.  Vera generated a lot of questions from her talk on the broad topic of point-of-care ultrasound, showing how the echo community can cooperate with the many physician groups performing ultrasound exams while still maintaining the primacy of the echo lab for complex diagnoses.  Vera also gave a great talk on mitral regurgitation, focusing on assessment of etiology and guidance of mitral valve repair and percutaneous mitral interventions.

Friday evening was the time for the Presidential Dinner for the Asia-Pacific Association of Echocardiography.  This was held at the President Chibo Restaurant, one of the best okonomiyaki establishments in town.  Okonomiyaki is something like a Japanese pizza or savory pancake, filled with scallions, cabbage, and pork, then topped with all kinds of delicious ingredients like shrimp, octopus, or squid.  The okonomiyaki is served at the end of the meal, after we had engorged ourselves on shrimp, giant clams, and kobe beef, all seared on a hot plate in front of us. It was a great opportunity to get to know the echo leadership from throughout the Asia-Pacific region.


Saturday, April 23, 2016:  Saturday was devoted overall to the AAE portion of the meeting with many English language sessions that Vera and I were heavily involved with, either chairing or speaking in.  Vera chaired the Ischemic Heart Disease session (with Tom Marwick), while I delivered a keynote address on assessment of diastolic function and chaired the New Technology session along with my former fellow and colleague Taka Shiota. Vera and Rhonda had the afternoon off, just enough time for a tour of Nara, the ancient capital, complete with the largest wooden building in the world, the largest seated Buddha in the world, and 1200 free roaming deer that will bow to you if you feed them! In the evening, the whole congress was invited for a fun time at Universal Studios Japan, complete with “real” American food (corn dogs and chicken nuggets, among other delectables) and a rather crazy review of Elvis impersonators and a dozen dancers and singers performing old pop and movie standards.  Not sure if this is what they really think America is like, but it was quite a caricature!


Sunday, April 24, 2016:  Time to go home after Vera and I had a pleasant stroll along the river.  We both flew from Osaka to Tokyo, then home to Chicago, although on different airlines.  Thankfully, I was able to finally get a taste of sushi in the United lounge at Narita before flying out.  All in all, it was a wonderful meeting with great opportunities to strengthen our ties to this important part of the world.

  President of the Japanese Society of Echocardiography Satoshi Nakatani.  Satoshi and I go back a long way to when he was a research fellow of mine in 1993-5, the first of 21 such fellows I’ve had over the years. 

Getting ready to break open the sake drum!  L to R: ASE Past-President Jim Thomas, JSE President Satoshi Nakatani, EACVI President Gilbert Habib, and AAE President Jae Oh.


ASE Vice-President Vera Rigolin, looking fresh as a daisy despite coming straight from the airport to the dinner, delivering greetings from ASE to the meeting.

  Another one of my fellows, Hirotsugu Yamada from Tokushima University (R) along with his mentor, Takashi Oki (L).

Here I am with Torhu Masuyama from Nishinomiya, who provided me with my first invitation to speak in Japan 25 years ago.


L to R: Vera Rigolin, Taka Shiota from Cedars Sinai Hospital (and yet another old fellow of mine), with ASE’s own Rhonda Price.


The room was packed as we awaited the food.  That’s Rhonda Price in the foreground.


Let the feast begin! A “Bavarese” of Pecorino Cheese.  (Not sure what that is, but it was tasty).

Seared Medium Fatty Tuna with Soft Boiled Egg and French Caviar.

   Short Pasta “Rizoni” with Spring Cabbage and Milan Salami.

Under this salt dome lay delicious Grilled Sea Bream with Green Pea Sauce.

   Sirloin Steak and Sauteed Foie Gras with Truffles and Marsala Sauce 
   Strawberry Tiramisu with “Fromage Blanc” Ice Cream. 
   Beautiful opera music from this pianist and tenor singer.
   Here he is singing an ode to a popular Japanese snack food made up of bean jam and mayonnaise on white bread, which we were provided with at the end of the evening.  Let’s just say it’s an acquired taste that I haven’t acquired!

And now, an operatic salute to Space Cruiser Yamato, a popular Japanese cartoon series.

Team ASE, ready for some rest before the real work of the meeting begins.  
   Here are Vera and I with Satoshi Nakatani. 

Here I am delivering my keynote speech on strain.  In the slide you can see a few of the 21 Japanese fellows I’ve had over the years.


The basics of generating strain maps.


A good audience for my talk.

   Vera Rigolin, delivering her keynote address on point-of-care echocardiography
   Two generations of former fellows, Kenya Kusunose (L, 2011-14) and Hiro Yamada (R, 2001-04), both now at Tokushima University.
  A prelude to the feasting at President Chibo okonomiyaki restaurant. Those shrimp were still kicking as they went on the grill, so definitely fresh!

This is the real deal: a king’s ransom worth of Kobe beef.



A fortune in abalones (aka giant sea snails) squirming on the hot plate.

   Crispy pork gyoza.

How the shrimp comes out. And yes, you’re expected to eat the head and the shell (and, yes, it’s actually quite tasty!).


The abalone as it comes out.


Kobe beef cooked to perfection with fried garlic chips.


And now the main event. Lots of okonomiyaki getting an expert application of mayonnaise.


And the finished product, a true Japanese pizza!


A few of the attendees after dinner. Front row (L to R): AAE President Jae Oh, JSE President Satoshi Nakatani, Chuwa Tei from Tokyo, and Li-Tan Yang from Taiwan.  Second row (L to R): Alex Lee from Hong Kong, Yun Zhang, president of the Chinese Society of Ultrasound in Medicine, Taka Shiota from Cedars Sinai in Los Angeles, Jong-Won Ha from Seoul, Korea, Jim Thomas from Northwestern University, Nitin Burkule, Past-President of the Indian Academy of Echocardiography, Tom Marwick from Melbourne, Australia, Andrew Li from Hong Kong, Jong-Min Song from Asan University in Korea (and yet another former fellow of mine), Yiting Fan from Hong Kong, and Kuan-Chih Huang from Taiwan (and YIA winner at the 3rd AAE in Taiwan 2015).


   Jae Oh, Satoshi Nakatani, and Taka Shiota presenting the first of two Young Investigator Awards to Yiting Fan from Hong Kong.  There was a tie in the results.

Jae Oh, Satoshi Nakatani, and Taka Shiota presenting the second of two Young Investigator Awards to Kanako Teramoto from Japan.  


Meanwhile, Vera and Rhonda were getting a great tour of the ancient Japanese capital of Nara.  Serving as tour guides are Yuko Soyama, one of Satoshi’s fellows, and Akiko Goda, staff cardiologist in his department.


A unique aspect of Nara is the 1200 deer that roam the streets freely.  And if you feed them, they’ll bow in gratitude!


The best way to get around Nara: rickshaw!  L to R: Vera Rigolin, Rhonda Price, Yuko Soyama, Akiko Goda

  And now we’re at the JSE/AAE Get-Together for the whole meeting at Universal Studios Japan.  Here I am with Nitin Burkule, Past President of the Indian Academy of Echocardiography

With Alex Lee from Hong Kong and one of his fellows, Yiting Fan, AAE Young Investigator Award co-winner


Yes, that’s Satoshi Nakatani joking it up with Japanese Elvis!


And the evening’s entertainment begins with a collection of show tunes.


Chuwa Tei being accosted by Woody Woodpecker’s girlfriend.


And here is group of us enjoying Woody’s girlfriend.


Lots of opportunities for audience participation!

   It was a real Vegas night.
   A salute to Titanic with one of the singers doing her best Kate Winslet impression.
   Yes, they’re singing “YMCA”.

 A Van Halen moment with Chuwa Tei and Jae Oh in mid-air during “Jump”.  
   A tribute to Lady Gaga

Yes, those outfits really do have electric lights on them.


Satoshi closing the evening’s entertainment and releasing the multitudes to enjoy the rides and shops in the park.

  Here I am with Marie Stugaart from Norway, whom I also count as one of my “Japanese” fellows, as she met her husband, a Japanese orthopedic surgeon, while doing her fellowship with me in 1993-5 and now lives mostly in Osaka

A happy crowd at the end of the evening.


Saying my good-byes to Satoshi on the final morning.  Congratulations on a job well done!


One of many ingenious appliances in Japan, an automated beer dispenser.  You place a glass on the platform, it tilts backwards so the beer goes in without foam, then it tilts back to vertical for the last bit of beer to provide the ideal head.  And don’t get me going on the toilets.  You need an engineering PhD to use them!


No sushi the whole weekend, but I was saved by the United lounge at Narita!