Yasuo Tsuda

Cataract in atomic bomb survivors.

Purpose: Ophthalmologic examinations were conducted on atomic bomb (A‐bomb) survivors 55 years after exposure. Materials and methods: A‐bomb survivors who had been exposed before 13 years of age at the time of the bombings in 1945 or who had been examined in a previous study between 1978 and 1980. The examinations, conducted between June 2000 and September 2002, included slit‐lamp examination, digital photography and a cataract grading system for three parts of the lens (nucleus, cortex and posterior subcapsule) as an outcome variable. Proportional odds logistic regression analysis was conducted using the lowest grading class as a reference and included explanatory variables such as age, sex, city, dose and various cataract‐related risk factors. When the grades in an individual differed, the worst grade was used. Results: Results indicate that odds ratios (ORs) at 1 Sv were 1.07 (95% confidence intervals [CI] 0.90, 1.27) in nuclear colour, 1.12 (95% CI 0.94, 1.30) in nuclear cataract, 1.29 (95% CI 1.12, 1.49) in cortical cataract and 1.41 (95% CI 1.21, 1.64) in posterior subcapsular cataract. The same was true after excluding 13 people whose posterior subcapsular cataracts had been previously detected. Conclusion: Significant radiation effects were observed in two types of cataracts in A‐bomb survivors.

Orbital Tumor in Acute Myeloid Leukemia Associated with Karyotype 46,XX,t(8;21)(q22;q22): A Case Report

Orbital tumor formation in acute myeloid leukemia (AML) is rare as an initial symptom. Furthermore, orbital granulocytic sarcoma (myeloid sarcoma) in pediatric patients is uncommon. We describe a 5-year-old Japanese girl with a left orbital mass as an initial symptom of AML, the mass revealed by computed tomography. Periperal blood and bone marrow pictures and a chromosomal analysis disclosing 46,XX,t(8;21)(q22;q22) showed AML (M2 according to the French-American-British classification). She was treated with antileukemic chemotherapy systemically. Three weeks after the initiation of chemotherapy, the orbital tumor regressed markedly. AML as an initial symptom of the orbital mass should be fully considered in a differential diagnosis, even in the absence of typical leukemic symptoms, and chromosomal analysis and immunophenotypical analysis may explain the pathogenesis of the extramedullary leukemic tumor.

Ocular injury caused by an air bag for a driver wearing eyeglasses.

BACKGROUND Although air bags have been shown to reduce the number of fatalities and serious injuries caused by motor vehicle accidents, there have been many reports of air bag-related ocular injuries. We recently treated air bag-related corneal laceration in a patient wearing eyeglasses at the time of a motor accident. CASE A 38-year-old Japanese man was driving a car at approximately 40 km per hour when he struck a stopped 2-ton truck. He was wearing a three-point lap-shoulder seat belt. At impact, the drivers-side air bag deployed and struck the man on the left side of his face. He was wearing eyeglasses with glass lenses, and the air bag broke the left lens of his eyeglasses, and glass fragments lacerated his cornea. OBSERVATIONS External examination showed multiple superficial abrasions of the skin and ecchymosis of the left side of his face. Slit-lamp examination of his left eye showed corneal laceration and hyphema. The lens had opacities and was covered with fibrin membrane. Repair of the corneal laceration and phacoemulsification of the lens were performed. Six months later, his best corrected visual acuity was 20/20 in the left eye. CONCLUSIONS As cars are increasingly equipped with air bags, reports of air bag-related eye injuries have increased. To our knowledge, this is the first reported case of corneal laceration caused by a shattered lens in an air bag-related injury. Ophthalmologists should caution patients about the danger of eye injuries in air bag-equipped cars, and thought should be given to improving the materials for eyeglasses.

Histologic study of living response to artificially synthesized hydroxyapatite implant : 1-year follow-up

&NA; We implanted artificially synthesized hydroxyapatite spheres into the orbits of 13 rabbits after enucleation. The spheres were removed 1, 2, 3, 6, and 12 months after implantation and examined by light and scanning electron microscopy. Tissue breakdown and exposure of the artificially synthesized hydroxyapatite implants were not observed. Month after month, fibrovascular tissues gradually invaded the pores of the artificially synthesized hydroxyapatite spheres deeper and deeper. Although the hydroxyapatite we used was completely artificially synthesized, we observed a mild foreign‐body reaction around the artificially synthesized hydroxyapatite spheres. After 12 months, however, relief of the foreign‐body reaction had occurred. Hydroxyapatite spheres for orbital implants after enucleation without scleral enveloping are appropriate.

Standard Values of Inter-inner Canthal, Inter-outer Canthal, and Inter-pupillary Distances in Normal Japanese Infants and Children

UNLABELLED PURPOSE AND MATERIALS: We studied inter-inner canthal distance(DIC), inter-outer canthal distance (DOC), and inter-pupillary distance (PD) in 1,006 normal Japanese infants and children to establish the normal ratio of DIC/PD and DOC/DIC for the diagnosis of congenital anomalies such as Waardenburg syndrome. RESULTS DIC, DOC, and PD increased significantly from one month after birth to 12 years of age. DIC and DOC were stable but PD increased from 13 years of age to 15 years of age in junior high school. The DIC/PD and DOC/DIC averages were 0.61 and 2.73, respectively, one month after birth and 0.63 and 2.69 at three months after birth. On the other hand, DIC/PD and DOC/DIC were stable at 0.55-0.59 and 2.45 from 8 to 15 years of age. CONCLUSION Since there have been no reports on standard values of DIC, DOC and PD in infants, we established the standard values in this study. These values are expected to be very useful in the diagnosis of neural crest cell migration anomalies, such as Waardenburg syndrome.