Background: Pulmonary embolism may develop due to unfavorable postearthquake living conditions and result in related deaths. Here we investigated the factors and characteristic ultrasonographic imag-ing features associated with fresh and chronic mixed venous thrombosis (FCMVT) in the calf of middle-aged and elderly people after a major disaster.Methods: We included 791 individuals who underwent screening for deep venous thrombosis (DVT). After obtaining written informed consent from all participants, we retrospectively investigated the fac-tors contributing to FCMVT and characteristic findings of FCMVT in the calf based on interviews and ultrasonography results.Results: Patients with FCMVT were significantly older and had knee osteoarthritis significantly more frequently than patients with DVT and patients without thrombosis. Characteristic ultrasonographic images of FCMVT showed thrombi with mixed echogenicity. We referred to these characteristic ultra-sonographic features as "the blowfish sign."Conclusion: In middle-aged and elderly people, a higher prevalence of knee osteoarthritis was associ-ated with FCMVT. FCMVT in the calf showed a characteristic finding termed as the blowfish sign.

Introduction: Tsunami victims of the Great East Japan Earthquake were screened for deep-vein thrombosis (DVT) in order to compare the DVT incidence rates between temporary and non-temporary housing resident groups. Material and methods: Lower extremity venous ultrasonography was performed on 290 subjects (64 men and 226 women; mean age = 71.9 ± 7.9 years) at 44 months after the disaster. All subjects completed questionnaires to gather information about their background factors which included the Kessler Psychological Distress Scale: K6. Results: The DVT detection rate was 10.7% in the temporary group. In the non-temporary group, it was 11.3% among the subjects who previously lived in temporary housing. For the subjects who were living in their own homes it was 9.2%. Psychological distress levels measured by K6 were significantly higher in the temporary housing group than in the non-temporary housing group. The multivariate analysis showed that the background factor associated with DVT risk was SV (soleal vein) dilatation in all subjects as well as in the non-temporary housing group, while hypertension and use of sleeping pills were found to be the factors in the temporary housing group. Conclusions: DVT detection rates were similar between the temporary and non-temporary housing groups, and were higher than that in the Japanese general population. The psychological distress level of the tsunami victims measured by K6 was also higher in the temporary housing group than in the non-temporary housing group. It is necessary to establish a long-term and awareness-raising disaster victim support system.

With the popularization of pulse wave signals by the spread of wearable watch devices incorporating photoplethysmography (PPG) sensors, many studies are reporting the accuracy of pulse rate variability (PRV) as a surrogate of heart rate variability (HRV). However, the authors are concerned about their research paradigm based on the assumption that PRV is a biomarker that reflects the same biological properties as HRV. Because PPG pulse wave and ECG R wave both reflect the periodic beating of the heart, pulse rate and heart rate should be equal, but it does not guarantee that the respective variabilities are also the same. The process from ECG R wave to PPG pulse wave involves several transformation steps of physical properties, such as those of electromechanical coupling and conversions from force to volume, volume to pressure, pressure impulse to wave, pressure wave to volume, and volume to light intensity. In fact, there is concreate evidence that shows discrepancy between PRV and HRV, such as that demonstrating the presence of PRV in the absence of HRV, differences in PRV with measurement sites, and differing effects of body posture and exercise between them. Our observations in adult patients with an implanted cardiac pacemaker also indicate that fluctuations in R-R intervals, pulse transit time, and pulse intervals are modulated differently by autonomic functions, respiration, and other factors. The authors suggest that it is more appropriate to recognize PRV as a different biomarker than HRV. Although HRV is a major determinant of PRV, PRV is caused by many other sources of variability, which could contain useful biomedical information that is neither error nor noise.

An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster.

For a period of 4 years, we conducted deep vein thrombosis (DVT) examinations among people living in temporary homes and those living in their own homes in areas affected by the Great East Japan Earthquake. We divided those with positive results for DVT after receiving numerous examinations into a DVT disappeared group and a DVT remained group. The thrombus formation sites were the soleus muscle veins for both groups. In terms of characteristics, multiple organized thrombi were recognized, and there was no spread to the central side. In addition, the DVT remained group exhibited an increased maximum diameter of the soleal vein. We believe that stasis of blood flow due to the extension of the soleal veins contributed to the continued formation of thrombi.

BackgroundTo evaluate the diagnostic performance of ultrasonography for screening of a population at risk for deep vein thrombosis (DVT) in a post-disaster setting. MethodsUltrasonography was applied as a screening technique to the residents of a temporary housing facility who were displaced following the Great East Japan Earthquake. Thirty DVT screening sessions were held from April 2013 to June 2015. Individuals were invited to participate if they were identified as high risk for DVT, defined as those with low activity levels, a history of lower limb trauma, baseline lower limb pain or swelling, a cancer-bearing status, or a history of venous thromboembolic event. Ultrasonographic examinations were performed from the calf to the popliteal veins using portable devices. ResultsOf the 3,316 subjects screened (682 men and 2,634 women) with a mean age of 71 9.7 years, DVT was diagnosed in 382 (11.5%). DVT was more likely in older, symptomatic, or female patients with a history of venous thromboembolism and attempting to perform daily exercise. The rate of DVT diagnosis increased from 9.9% in 2013 to 13.5% in 2015. ConclusionsUltrasonography is efficient for screening at-risk populations in challenging settings. (c) 2017 Wiley Periodicals, Inc. J Clin Ultrasound45:566-574, 2017

Introduction: The aim of this study is to clarify the important role of deep venous thrombosis (DVT) in disaster refugees. Methods: We visited the Minami-sanriku Tome shelter in Miyagi Prefecture, one of the areas affected by the Great East Japan Earthquake, to examine the incidence of DVT by using an ultrasound device from March 14 to May 4, 2011. One hundred eighty-seven people, who were aged over 60 years and had lower limb trauma, lower limb symptoms, a history of lengthy periods of resting inside a car, and/or a motionless lifestyle in the shelter, participated in the examination. The ultrasound examination was mainly intended to check for DVT findings below the knee. Results: The incidence of DVT in the participants was 5.3% (10/187). When comparing those with DVT with those without, age, percentage of women, and percentage with lower limb trauma were significantly higher in DVT patients than in non-DVT people. After logistic regression analysis, lower limb trauma was an independent strong risk factor for DVT (p < 0.0001, odds ratio=26.5). Conclusion: In conclusion, lower limb trauma is the most important cause of DVT formation in disaster refugees.

Atrial fibrillation (AF) disrupts movement of the left atrium (LA) and worsens the vital prognosis by causing thromboembolism. Ultrasound Doppler measurement, phase-contrast magnetic resonance imaging (PC MRI), as well as computational fluid dynamics (CFD) have revealed hemodynamic changes in the LA due to AF, such as stagnation of blood flow in the left atrial appendage (LAA). However, quantitative evaluation of the hemodynamics during AF has not been conducted, and the effects of important AF characteristics, such as a lack of active contraction of the LA (atrial kick) in late diastole and the occurrence of high-frequency fibrillation (>400bpm) of the atrial wall, on blood flow field and concomitant hemodynamic stresses have not been completely understood. In this study, the effects of the above-mentioned two characteristic phenomena of AF on blood flow and hemodynamic parameters were quantitatively investigated. Based on MRI of a healthy volunteer heart, one healthy LA model and two AF models (one without atrial kick, and one without atrial kick and with high-frequency fibrillation) were constructed to perform hemodynamic analysis, and the computational results were compared. The results revealed that each characteristic phenomenon of AF influenced hemodynamics. Especially, atrial wall movement by high-frequency fibrillation had a large impact on the stagnation of blood flow. The relative residence time (RRT), which is an indicator of stagnation of blood flow, increased in the upper part of the LAA during AF. This result implies that there is a local thrombus-prone site in LAA when AF occurs.

After the Great East-Japan Earthquake, the prevalence of deep vein thrombosis (DVT) in disaster shelters in Ishinomaki (Pacific coast, Miyagi, Japan) was found much higher than that ever reported in Japan. In Ishinomaki, twelve patients were found to have pulmonary thromboembolism for one month since the earthquake and DVT was found in 10 of those patients. The calf DVT was examined using ultrasonography in the shelters (from March to July 2011) and in temporary emergency housings (from August to December 2011). Calf DVT was found in 190 of 701 evacuees. DVT prevalence was higher in the tsunami-flooded shelters (34.2%) than in that in the non-flooded shelters (19.1%). This indicated that deteriorated and crowded condition in the tsunami-flooded shelters might induce thrombogenesis in calf veins. Therefore, evacuees were recommended to leave tsunami-flooded areas. DVT prevalence in the shelters was gradually reduced, however, that was still higher in the temporary emergency housings (8.9%) than in the non-disaster area in Japan (2.2% in Yokohama city). The risk of calf DVT in the temporary emergency housings was increased because of reduced blood flow in the calf veins caused by immobility. The residents of the housings were required to be physically active to avoid calf DVT. (English translation of Jpn J Phlebol 2013; 24: 380-384).

In March 11, 2011, worst disaster called Sendai Quake attacked the north east side of Japan. In the disaster area, Tsunami removed the all building, so, we need simple and easy medical equipment. As the portable device, Electric doctor bag has been invented. In the traditional and alternative medicine, a pulse diagnosis is one of the most important diagnostic methods. However, there was no paper in which the medical evidence of a pulse diagnosis was shown. We invented the quantitative diagnosis machine which could carry out a pulse diagnosis scientifically. This machine could perform a pulse diagnosis using three pressure sensors. The pulse diagnosis is reproduced by various pressures being applied to three pressure sensors from external surface. Three experimental series including the experiments using model circulation circuit, an animal experimental series, and a clinical application with pulse diagnosis machine were conducted. Chaos theory was used for the evaluation in the clinical application of the pulse diagnosis machine. At least as for the part, the data which are in agreement with a traditional Chinese medicine by this pulse diagnosis machine are obtained. A part of Chinese medicine may have the scientific basis medically, in future. Scientific evidence may be able to be given to a pulse diagnosis for the first time in the world using invention of this pulse diagnosis machine.

要約：2004 年に発生した新潟県中越地震以降，避難所/ 仮設住宅における高い深部静脈血栓症（DVT）発生頻度とその後も遷延することが報告されている．2011 年に発生した東日本大震災後に栗原市内に設けられた南三陸町民に対する2 次避難所において，検査希望者もしくは検査を推奨される方に対し問診，視診，下腿静脈エコーを行った．下肢静脈エコーは，非圧迫所見もしくは直接的な血栓エコーの存在にて血栓陽性と判定した．2011 年4 月11 日から7 月29 日までに計5 回の巡回検査を行い，103 名（延べ166名）の避難者に対して検査を行った．103 名中10 名（延べ21 名）にDVT を認め，抗凝固療法を受けた7 名では観察期間中4 名で血栓の消失を確認した．整備された2 次避難所では良好な避難所環境や医療アクセスによる抗凝固療法の後押しもあり，血栓は消失もしくは沈静化する方向にあった．

Artificial OrgansVolume 36, Issue 8 p. 760-763 Medical Responses Following the Sendai Quake (East Japan Earthquake, March 11, 2011) Tomoyuki Yambe, Corresponding Author Tomoyuki Yambe Tohoku University, SendaiDr. Tomoyuki Yambe, Department of Medical Engineering and Cardiology, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. E-mail: [email protected]Search for more papers by this authorMuneichi Shibata, Muneichi Shibata Miyagi Cardiovascular Respiratory Center, MiyagiSearch for more papers by this authorTaketada Sumiyoshi, Taketada Sumiyoshi Miyagi Cardiovascular Respiratory Center, MiyagiSearch for more papers by this authorYoshiaki Mibiki, Yoshiaki Mibiki Miyagi Cardiovascular Respiratory Center, MiyagiSearch for more papers by this authorNoboru Osawa, Noboru Osawa Miyagi Cardiovascular Respiratory Center, MiyagiSearch for more papers by this authorYoshiaki Katahira, Yoshiaki Katahira Tohoku Kouseinenkin Hospital, SendaiSearch for more papers by this authorMinoru Yambe, Minoru Yambe Tohoku Kouseinenkin Hospital, SendaiSearch for more papers by this authorKou-ichi Tabayashi, Kou-ichi Tabayashi Tohoku Kouseinenkin Hospital, SendaiSearch for more papers by this authorMasanori Yamashina, Masanori Yamashina Sendai City Hospital, SendaiSearch for more papers by this authorEiji Sato, Eiji Sato Sendai City Hospital, SendaiSearch for more papers by this authorShinichi Sato, Shinichi Sato Sendai City Hospital, SendaiSearch for more papers by this authorTetsuo Yagi, Tetsuo Yagi Sendai City Hospital, SendaiSearch for more papers by this authorMakoto Watanabe, Makoto Watanabe Miyagi Shakaihoken Hospital, SendaiSearch for more papers by this authorYoshihira Akinno, Yoshihira Akinno Miyagi Shakaihoken Hospital, SendaiSearch for more papers by this authorMasanori Munakata, Masanori Munakata Tohoku Rosai Hospital, SendaiSearch for more papers by this authorNaoki Owada, Naoki Owada Miyagi Cancer Center, Natori, JapanSearch for more papers by this authorMasatoshi Akiyama, Masatoshi Akiyama Tohoku University, SendaiSearch for more papers by this authorYoshikatsu Saiki, Yoshikatsu Saiki Tohoku University, SendaiSearch for more papers by this authorNorihiro Sugita, Norihiro Sugita Tohoku University, SendaiSearch for more papers by this authorMakoto Yoshizawa, Makoto Yoshizawa Tohoku University, SendaiSearch for more papers by this author Tomoyuki Yambe, Corresponding Author Tomoyuki Yambe Tohoku University, SendaiDr. Tomoyuki Yambe, Department of Medical Engineering and Cardiology, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. E-mail: [email protected]Search for more papers by this authorMuneichi Shibata, Muneichi Shibata Miyagi Cardiovascular Respiratory Center, MiyagiSearch for more papers by this authorTaketada Sumiyoshi, Taketada Sumiyoshi Miyagi Cardiovascular Respiratory Center, MiyagiSearch for more papers by this authorYoshiaki Mibiki, Yoshiaki Mibiki Miyagi Cardiovascular Respiratory Center, MiyagiSearch for more papers by this authorNoboru Osawa, Noboru Osawa Miyagi Cardiovascular Respiratory Center, MiyagiSearch for more papers by this authorYoshiaki Katahira, Yoshiaki Katahira Tohoku Kouseinenkin Hospital, SendaiSearch for more papers by this authorMinoru Yambe, Minoru Yambe Tohoku Kouseinenkin Hospital, SendaiSearch for more papers by this authorKou-ichi Tabayashi, Kou-ichi Tabayashi Tohoku Kouseinenkin Hospital, SendaiSearch for more papers by this authorMasanori Yamashina, Masanori Yamashina Sendai City Hospital, SendaiSearch for more papers by this authorEiji Sato, Eiji Sato Sendai City Hospital, SendaiSearch for more papers by this authorShinichi Sato, Shinichi Sato Sendai City Hospital, SendaiSearch for more papers by this authorTetsuo Yagi, Tetsuo Yagi Sendai City Hospital, SendaiSearch for more papers by this authorMakoto Watanabe, Makoto Watanabe Miyagi Shakaihoken Hospital, SendaiSearch for more papers by this authorYoshihira Akinno, Yoshihira Akinno Miyagi Shakaihoken Hospital, SendaiSearch for more papers by this authorMasanori Munakata, Masanori Munakata Tohoku Rosai Hospital, SendaiSearch for more papers by this authorNaoki Owada, Naoki Owada Miyagi Cancer Center, Natori, JapanSearch for more papers by this authorMasatoshi Akiyama, Masatoshi Akiyama Tohoku University, SendaiSearch for more papers by this authorYoshikatsu Saiki, Yoshikatsu Saiki Tohoku University, SendaiSearch for more papers by this authorNorihiro Sugita, Norihiro Sugita Tohoku University, SendaiSearch for more papers by this authorMakoto Yoshizawa, Makoto Yoshizawa Tohoku University, SendaiSearch for more papers by this author First published: 06 August 2012 https://doi.org/10.1111/j.1525-1594.2012.01522.xCitations: 2 Presented in part at the 19th Congress of the International Society for Rotary Blood Pumps, held on September 8–10, 2011, in Louisville, KY, USA. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume36, Issue8August 2012Pages 760-763 RelatedInformation

●要 約：2008年岩手・宮城内陸地震および2011年東日本大震災発生後，携帯型超音波診断装置を用いた深部静脈血栓症(DVT)スクリーニング検査を避難所にて行った．対象は岩手・宮城内陸地震発生後3年目，東日本大震災発生後5週目までに検査を行ったそれぞれ127名，330名である．東日本大震災発生後5週目までのDVT発生リスク要因分析を多変量解析にて行い，岩手・宮城内陸地震発生後3年目までに追跡し得たDVT陽性20例をもとにKaplan-Meier法を用いて経時的なDVT残存率を推定した．東日本大震災では74例(22%)にDVTを認め，下肢外傷，トイレを控えたことが統計学的に有意であった．また岩手・宮城内陸地震後の追跡調査では1年半までにDVT残存率は55%まで漸減し，3年後には16%へ低下した．遷延するDVTの存在を考慮すると災害時における静脈血栓塞栓症対策には早期のDVT予防介入と継続したフォローアップ検査が重要であると考えられた．

Coronary arteries connecting to septal branch are often occluded in post-coronary artery bypass graft cases. A 70-year-old male had undergone CABG; radial artery graft to the LCX, and gastroepiploic artery (GEA) graft to the RCA. Coronary angiography revealed total occlusion in proximal LAD, while both graft vessels had good flow. Retrograde percutaneous coronary intervention (PCI) procedure from the septal channel via GEA graft to the RCA was performed for total occlusion of LAD. Despite the tortuous GEA, deep engagement with a 4-french guiding catheter ensured powerful back-up force. After retrograde wire crossing, two drug-eluting stents were implanted, successfully.

High prevalence of deep vein thrombosis (DVT) in disaster shelters has been reported in the aftermath of earthquakes in Japan. Calf DVT was examined using sonography in the shelters after the Great East Japan earthquake on March 11, 2011. By the end of July 2011, 701 out of 8,630 evacuees suspected with calf DVT, judged by inspections or medical interviews, were examined in 32 shelters, and 190 evacuees were confirmed to have calf DVT. The prevalence of DVT was 2.20%, which was 200 times higher than the usual incidence in Japan. The DVT prevalence seemed to decrease with time. By the end of May, a significantly higher prevalence of DVT was found in tsunami-flooded shelters (109 of 3,871 evacuees; 2.82%) than in non-flooded shelters (53 of 3,155 evacuees; 1.68%). After June, its prevalence was still higher (18/541; 3.33%) in tsunami-flooded shelters than in non-flooded shelters (10/1063; 0.94%). The cause of the high prevalence of DVT was supposed to be dehydration due to the delay in supplying drinking water, vomiting, and diarrhea experienced by the evacuees because of a shortage of clean water to wash their hands. Dehydration was especially noticed in women because they restricted themselves of water intake to avoid using unsanitary toilet facilities. Moreover, crowded shelters restricted the mobility of elderly people, which would exacerbate the prevalence of DVT. Those deteriorated and crowded shelters were observed in tsunami-flooded areas. Therefore, long-term shelters should not be set up in flooded areas after tsunami.

It is well known that the baroreflex system is one of the most important indicators of the pathophysiology in hypertensive patients. We can check the sensitivity of the baroreflex by observing heart rate (HR) responses; however, there is no simple diagnostic method to measure the arterial behavior in the baroreflex system. Presently, we report the development of a method and associated hardware that enables the diagnosis of baroreflex sensitivity by measuring the responses of both the heart and the artery. In this system, the measurements are obtained by monitoring an electrocardiogram and a pulse wave recorded from the radial artery or fingertip. The arterial responses were measured in terms of the pulse wave velocity (PWV) calculated from the pulse wave transmission time (PTT) from the heart to the artery. In this system, the HR change corresponding to the blood pressure change in time series sequence was observed. Slope of the changes in blood pressure and HR indicated the sensitivity of the baroreflex system of the heart. This system could also measure the sensitivity of the baroreflex system of an artery. Changes in the PWV in response to the blood pressure changes were observed. Significant correlation was observed in the time sequence between blood pressure change and PWV change after calculating the delay time by cross-correlation. The slope of these parameter changes was easily obtained and it demonstrated the sensitivity of the baroreflex system of an artery. We evaluated this method in animal experiments using rotary blood pump (RBP) with undulation pump ventricular assist device, and PTT elongation was observed in response to increased blood pressure with RBP assistance. Furthermore, when tested clinically, decreased sensitivity of the baroreflex system in hypertensive patients was observed. This system may be useful when we consider the ideal treatment and follow-up of patients with hypertension.