One-year recurrence rate of Graves ophthalmopathy presenting as diplopia in the primary position after varied doses of intravenous methylprednisolone followed by oral prednisolone with dosing based on the magnetic resonance imaging findings.

PURPOSE: To reveal the recurrence rate of Graves ophthalmopathy (GO) presenting as diplopia in the primary position for 1 year after varied doses of intravenous methylprednisolone (IVMP) followed by oral prednisolone, with dosing based on the magnetic resonance imaging (MRI) findings. STUDY DESIGN: Retrospective study. METHODS: We analyzed the medical charts of 25 patients who were diagnosed with new-onset GO and who received treatment for diplopia in the primary position at our hospital. Treatment consisted of MRI-determined varied doses of IVMP followed by oral prednisolone. If the MRI findings showed deterioration or were unchanged after 6 g of IVMP, 3 g of IVMP was added for further treatment. Simple and multiple linear regression analyses were performed to reveal the associations between the independent variables and the dependent variable, defined as recurrence. RESULTS: The mean patient age (± standard deviation) was 61.3 ± 11.3 years. The female to male ratio was 15:10. Twenty-one of the 25 patients received a total of 6 g of IVMP, whilst the remaining 4 patients received a total of 9 g of IVMP. In 5 patients (20%), the GO recurred within 1 year of IVMP administration. Simple and multiple linear regression analyses showed that the MRI findings after 6 g of IVMP affected recurrence (P < .05). CONCLUSION: This study showed that in 20% of patients, GO recurred within 1 year of administration of varied doses of IVMP, with the dosing based on the MRI findings. Furthermore, assessment of inflammation by use of MRI after 6 g of IVMP has a potential role in predicting recurrence.

Posterior microphthalmos with achievement of good visual acuity and disappearance of papillomacular retinal folds: a case report.

BACKGROUND: Posterior microphthalmos (PM) is a rare condition with poor visual prognosis even after amblyopia treatment. We report a case of PM with achievement of good visual acuity and disappearance of papillomacular retinal folds (PFs) over a period of 7 years. CASE PRESENTATION: A girl aged 3 years and 5 months was referred to our hospital, after poor visual acuity was identified at a medical checkup for 3-year-olds. She had severe spherical hyperopia: + 17.25 D in the right eye (RE) and + 18 D in the left eye (LE). Her corrected visual acuity was 20/200 in the RE and 20/250 in the LE. PFs were observed in both eyes on optical coherence tomography (OCT), and the diagnosis of PM was made based on the normal corneal diameter and anterior chamber depth. During the course of the disease, a gradual decrease in the height of the PFs was observed on OCT. The corrected visual acuity at age 10 years was 20/20 in the RE and 20/25 in the LE. CONCLUSIONS: The visual prognosis of PM is poor, and only one case with good visual acuity has been reported in the literature. The patient in the present case not only developed good visual acuity, but also showed improvement in macular morphology, which was not noted in previous reports. Early diagnosis of PM and early amblyopia treatment is important for the visual development in PM.

Pancreatoblastoma. A case report with special emphasis on squamoid corpuscles with optically clear nuclei rich in biotin.

BACKGROUND: Pancreatoblastoma (PBL) is a rare neoplasm that generally occurs in the pediatric age group and shows unique histopathology, including squamoid corpuscles that may contain tumor cells with optically clear nuclei (OCN) rich in biotin. In the English-language literature there have been two reports on the cytology of PBL, but neither of them refers to the cytologic features of squamoid corpuscles. CASE: A 3-year-old boy with nausea and general fatigue was referred to our center. Imaging studies showed an approximately 7.5-cm, left-sided abdominal mass and multiple metastases in the lung. The abdominal mass was biopsied, and its histology showed solid cellular nests with occasional acinar differentiation and squamoid corpuscles. Imprint cytology of the biopsied sample displayed cellular epithelial nests with focal acinar structures and foci composed of larger cells with a low nuclear/cytoplasmic ratio. These foci contained a few tumor cells with biotin-rich OCN and were determined to be squamoid corpuscles. CONCLUSION: Detection of occasional squamoid corpuscles with biotin-rich OCN can be useful in making a diagnosis of PBL on cytologic samples.

Determination of Ethyl Carbamate in Various Fermented Foods by Selected Ion Monitoring.

A simple and sensitive method for the determination of ethyl carbamate (urethane) in various fermented foods has been developed. Twenty g of sample was homogenized and extracted with 150 ml of acetone. Twenty ml of water was added to the extract which was then evaporated to remove organic solvent. The residual aqueous solution was extracted three times with 100 ml of dichloromethane. The organic layer was concentrated by rotary evaporator and was charged on an acid-celite column. After washing the column with 100 ml of pentane and 100 ml of pentane-dichloromethane mixture (80:20), ethyl carbamate was eluted with 60 ml of dichloromethane. The eluant was concentrated to 1 ml using a rotary evaporator, and ethyl carbamate was determined by gas chromatography-mass spectrometry in the selected ion monitoring mode. For liquid samples, extraction with acetone was not necessary. The column purification step was also unnecessary for alcoholic beverages. The detection limit for this procedure was 0.5 ppb/sample, and the recovery was 70 to 105% for miso, moromi, natto, soy sauce, sake, yogurt, and bread when they were fortified with 5 to 50 ppb of ethyl carbamate. Ethyl carbamate levels in various fermented foods including yogurt, bread, mirin, or sakekasu were determined by this method. Relatively high levels of ethyl carbamate were detected in sake and soy sauce.

Determination and Identification of Daminozide in Fresh Fruits Purchased in Japan.

The concentration of residual daminozide (trade name of formulation: Alar or B-Nine) in cherries, grapes, peaches, and apples purchased in Japan was investigated using the colorimetric method. Daminozide hydrolyzes in boiling strong alkaline solution to release unsymmetrical dimethylhydrazine which is distilled and reacted with trisodium pentacyanoamine ferroate to form a specific red color at pH 4.5. This color is measured spectrophotometrically. The levels of daminozide detected were 0.07-1.39 ppm in cherries (11 samples), 0-0.36 ppm in grapes (10 samples), 0-0.42 ppm in peaches (9 samples), and 0-0.88 ppm in apples (10 samples). Furthermore, daminozide in each sample was identified as methyl daminozide by the gas chromatography/mass spectrometry (GC/MS) method.

Simultaneous Determination of Ten Kinds of Organochlorine Insecticides in Beef by Gas Chromatography.

A simple and rapid method for simultaneous determination of 10 kinds of organochlorine insecticides (ß-BHC, heptachlor, heptachlor epoxide, aldrin, dieldrin, endrin, p,p'-DDT, p,p'-DDE, p,p'-DDD, t-chlordane) in beef was established. The pesticides were extracted from samples with acetone hexane (3:1) mixture, and purified by Florisil column chromatography, then determined by use of a gas chromatograph equipped with an electron capture detector (ECD-GLC). Recoveries of the 10 pesticides added to beef at 0.02 ppm and 0.1 ppm were within the range of 63.9 - 89.0% and 76.8 - 90.5% by the proposed method, respectively. One hundred and twenty six samples of Australian beef received at the Osaka and Kobe quarantine stations from August to December in 1987 were analyzed, and only one sample was over the limit of dieldrin (+aldrin) referring to Japanese temporary tolerance.

Determination of Ethylene Dibromide in Tropical Fresh Fruits Using Dean-Stark Apparatus and ECD-Gas Chromatography.

The concentration of residual EDB (ethylene dibromide) in tropical fresh fruits imported to Japan were investigated using the Dean-Stark apparatus and ECD-gas chromatography (ECD-GC) i.e. EDB was distilled into a small amount of n-hexane using a Dean-Stark apparatus and determined by ECD-GC. Recovery of EDB added to papaya pulp at the concentration of 0.1 ppm was more than 98.1% by the proposed method. The relationship between storage conditions and concentration of residual EDB was investigated for mango pulps; it was clarified that EDB content in mango pulps decreased with the storage time at room temperature (25°C) and refrigerated (7°C), but the content did not decrease for 6 d at -20°C. We surveyed the concentration of residual EDB in pulps, peels and seeds of the fresh fruits (grapefruits, papayas, mangos and litchis) imported to Japan in 1987 separately. Extremely high concentrations of EDB were found in the seeds of grapefruits. A similar trend was also observed in other fruits.