Two Cases of Serous Retinal Detachment Following Vitrectomy in Patients with Proliferative Diabetic Retinopathy

PURPOSE: In the present study, 2 cases of serous retinal detachment in patients diagnosed with proliferative diabetic retinopathy after pars plana vitrectomy are reported. CASE SUMMARY: (Case 1) A 38-year-old female diagnosed with high-risk proliferative diabetic retinopathy underwent pars plana vitrectomy and cataract surgery due to intravitreal hemorrhage. One day after the operation, fundus photograph and optical coherence tomography (OCT) revealed serous retinal detachment. After ensuring that no retinal hole was present based on fundus examination, the patient was diagnosed with serous retinal detachment and antimicrobial and steroid eye drops were applied. After 1 week, subretinal fluid disappeared. (Case 2) A 63-year-old male diagnosed with proliferative diabetic retinopathy underwent pars plana vitrectomy due to right vitreous hemorrhage. On postoperative day 1, focal subretinal fluid under the macula was observed using OCT. Intravitreal triamcinolone injection was performed during surgery and steroid eye drops were applied. Subretinal fluid collection was absorbed 5 days postoperatively. CONCLUSIONS: Two cases of serous retinal detachment that occurred postoperatively in patients with diabetic retinopathy are reported. Serous retinal detachment was resolved after several days without specific management.

Evaluation of Visual Outcome after Cataract Surgery in Patients Aged 85 Years or Older

PURPOSE: To compare the visual outcome after cataract surgery in patients 85 years of age or older with those in other age groups. METHODS: This retrospective study included 313 eyes of 204 patients who underwent cataract surgery from April 2014 to March 2015 at Kangwon National University Hospital and were followed up or 3 months or longer. The patients were divided into groups A (86 eyes of 53 patients between 55 and 69 years of age), B (85 eyes of 53 patients between 70 and 84 years of age), and C (143 eyes of 98 patients 85 years of age or older), and the medical records of the patients were reviewed and analyzed. RESULTS: The postoperative best-corrected visual acuity (BCVA) improved in 95% of group A patients, 87% of group B, and 81% of group C. When compared with the log MAR BCVA before and after surgery, the visual acuity after cataract surgery was improved effectively from 0.40 to 0.06 in group A, from 0.50 to 0.16 in group B, and from 0.75 to 0.31 in group C (p < 0.001). In group C, preoperative and postoperative BCVAs were significantly worse than in other groups (p < 0.001 and < 0.001, respectively) and the ratio of patients with vision improvement and patients with BCVA of 20/40 or better was significantly lower than in the other groups (p = 0.009 and < 0.001, respectively). CONCLUSIONS: The ratio of visual acuity improvement was decreased among the patients over 85 years of age. Pre and postoperative visual acuities in group C were observed worse than in other groups. Additionally, the postoperative visual acuity was low. However, average visual acuity improved in 81% of patients. Therefore, cataract surgery should be strongly recommended for very old patients.

Postoperative Refractive Errors after Posterior Capsulectomy during Combined Vitrectomy and Cataract Surgery

PURPOSE: To evaluate the difference between the predicted and actual postoperative refractions after combined vitrectomy and cataract surgeries with a posterior capsulectomy. METHODS: We performed a retrospective study of 33 eyes of 33 patients who underwent combined vitrectomy and cataract surgeries in our hospital between March 2013 and May 2014. The patients were divided into 2 groups: those who underwent a posterior capsulectomy (group A) and those who underwent combined vitrectomy and cataract surgeries (group B). The actual refractive errors were analyzed 3 months after surgery using spherical equivalent. We compared the results between the predicted and actual refractive errors in the two groups. RESULTS: Group A consisted of 25 eyes of 25 patients and group B of 8 eyes of 8 patients. In group A, the average difference between predicted and actual postoperative refractive errors was -0.16 +/- 0.38 D (p = 0.083). The predicted refraction was -0.33 +/- 0.46 D and actual refraction was -0.49 +/- 0.55 D in group A. There was no statistically significant difference between the predicted refraction and actual refractive errors in group A (p = 0.083). In group B, the average difference between predicted and actual postoperative refractive errors was 0.27 +/- 0.29 D (p = 0.078). Additionally, the predicted refraction was -0.49 +/- 0.77 D and actual refraction was -0.22 +/- 0.59 D. The difference between the predicted refraction and actual refractive errors in group B was not statistically significant (p = 0.078). CONCLUSIONS: When a posterior capsulectomy is performed during combined vitrectomy and cataract surgery, no significant difference in refractive errors between the predicted refraction and actual refractive errors was observed 3 months after surgery. Compared with combined vitrectomy and cataract surgeries only, a small amount of myopic refractive change tended to occur 3 months after surgery.

Correlation between Intraocular Pressure and Bottle Heights during Vitrectomy

PURPOSE: To determine the correlation between intraocular pressure (IOP) and the bottle heights during vitrectomy using TONO-PEN(R)XL applanation tonometer and Icare(R) PRO rebound tonometer. METHODS: Twenty-four eyes of 24 patients who underwent 23-gauge sutureless vitrectomy were evaluated. After complete vitrectomy, the IOP was gradually increased by lifting the irrigation bottle height from the trocar insertion site by 40 cm, 45 cm, 50 cm, and 55 cm. The distance between the floor and patient's eye was consistent in all cases (105.5 cm). Before the removal of 23-gauge microcannulas, IOP was measured five times using each of the two methods, Tono-Pen(R)XL and Icare(R) PRO. RESULTS: The mean IOPs were 8.25 +/- 0.35 mm Hg for TONO-PEN(R)XL and 8.96 +/- 0.32 mm Hg for Icare(R) PRO at 40 cm bottle height. As the bottle height increased, the differences in IOP was also increased, 10.71 +/- 0.37 mm Hg at 45 cm, 14.18 +/- 0.39 mm Hg at 50 cm and 17.93 +/- 0.40 mm Hg at 55 cm for TONO-PEN(R)XL and 11.48 +/- 0.31 mm Hg at 45 cm, 14.64 +/- 0.31 mm Hg at 50 cm and 18.13 +/- 0.38 mm Hg at 55 cm for Icare(R) PRO. In TONO-PEN(R)XL, the linear equation was Y = 0.65 X - 18.108 (R2 = 0.794, p = 0.000) and the quadratic equation was Y = 0.013 X2 - 0.569 X + 10.446 (R2 = 0.801, p = 0.000). In Icare(R) PRO, the linear equation was Y = 0.614 X - 15.842 (R2 = 0.820, p = 0.000) and the quadratic equation was Y = 0.010 X2 - 0.306 X + 5.688 (R2 = 0.825, p = 0.000). The results show correlation of the quadratic equation was stronger than the linear equation in both tonometers. CONCLUSIONS: The differences of IOP were positively correlated with bottle heights in the form of a curve during vitrectomy. Therefore, the patients who are susceptible to retina or optic nerve damage during vitrectomy should be closely monitored.

Learning Curve for Strabismus Surgery

PURPOSE: In the present study, we evaluated the learning curve of strabismus surgery performed by a single surgeon. METHODS: We reviewed the data of 62 patients with exodeviation who underwent strabismus surgery and were followed up for at least 3 months between March 2011 and November 2014. Patients were divided into 3 groups classified chronologically and the success rate in each group was investigated. Additionally, the results of exotropia surgery were analyzed using cumulative sum (CUSUM) analysis. We compared 5 m distal angle deviation preoperatively and 3 months after strabismus surgery. RESULTS: The overall surgical success rate of 62 patients was 72.6% (45/62). Success rates were 70% (14/20) in the first group, 71.4% (15/21) in the second group and 76.2% (16/21) in the third group. CUSUM analysis indicated that a surgeon's performance begins to improve at attempt number 11 and cumulative failure chart suggested the surgeon had achieved acceptable level of performance after 44 surgeries. CONCLUSIONS: A novice strabismus surgeon showed performance improvement after 11 cases and achieved acceptable level of performance after 44 strabismus surgeries. Although additional statistical data using more cases is needed, we suggest surgeons should perform at least 50 strabismus surgeries to ensure a high success rate.

Effect of Sodium Hyaluronate and Cyclosporine A on Tear Film in Dry Eye Syndrome

PURPOSE: To evaluate the efficacy of topical 0.1% hyaluronate (HA) and 0.05% cyclosporine A on tear film parameters in dry eye syndrome patients. METHODS: Patients who were diagnosed with dry eye syndrome were treated with mbined with cyclosporine A (Group 2, 54 eyes). Ocular surface disease index (OSDI), tear film break-up time (BUT), Schirmer's test, and tear osmolarity were evaluated before treatment and at 1, 2, 3, and 6 months after treatment. RESULTS: OSDI was significantly improved at 2 months after treatment and Schirmer's test results significantly improved at 1 month after treatment in both groups. The BUT was significantly improved 3 months after treatment in Group 1 and at 1 month after treatment in Group 2. Tear osmolarity significantly improved at 1 month after treatment in both groups, but continuously improved up to 6 months after treatment only in Group 2. The BUT and Schirmer's test showed greater improvements in Group 2 than in Group 1. CONCLUSIONS: Combined treatment of topical 0.1% HA and 0.05% cyclosporine A may be more effective for improving dry eye syndrome.

Molecular Identification and Real-time Quantitative PCR (qPCR) for Rapid Detection of Thelohanellus kitauei, a Myxozoan Parasite Causing Intestinal Giant Cystic Disease in the Israel Carp

Intestinal giant-cystic disease (IGCD) of the Israel carp (Cyprinus carpio nudus) has been recognized as one of the most serious diseases afflicting inland farmed fish in the Republic of Korea, and Thelohanellus kitauei has been identified as the causative agent of the disease. Until now, studies concerning IGCD caused by T. kitauei in the Israel carp have been limited to morphological and histopathological examinations. However, these types of diagnostic examinations are relatively time-consuming, and the infection frequently cannot be detected in its early stages. In this study, we cloned the full-length 18S rRNA gene of T. kitauei isolated from diseased Israel carps, and carried out molecular identification by comparing the sequence with those of other myxosporeans. Moreover, conventional PCR and real-time quantitative PCR (qPCR) using oligonucleotide primers for the amplification of 18S rRNA gene fragment were established for further use as methods for rapid diagnosis of IGCD. Our results demonstrated that both the conventional PCR and real-time quantitative PCR systems applied herein are effective for rapid detection of T. kitauei spores in fish tissues and environmental water.

Prognostic Factors in Vitrectomy for Macular Epiretinal Membrane

PURPOSE: To identify prognostic factors associated with a favorable outcome after vitrectomy for patients with macular epiretinal membrane (ERM). METHODS: The authors retrospectively reviewed the records of 63 patients (64 eyes) with macular ERM, who were treated by vitrectomy between 2003 and 2008, and followed for more than 6 months. RESULTS: The mean follow-up period was 13.21 +/- 9.11 months and the mean best corrected visual acuity after vitrectomy was log MAR 0.32 +/- 0.34. Univariate analysis revealed the patients in the group with a postoperative log MAR of 0.3 or better had better preoperative visual acuity and shorter symptom duration; multivariate analysis revealed the same results. In 24 eyes, intraretinal structures which contained pseudoholes, intraretinal cysts, retinal folds and vitreoretinal traction were analyzed with Cirrus HD-OCT, however, there was no correlation with visual acuity after vitrectomy. CONCLUSIONS: The present study demonstrated vitrectomy for macular ERM resulted in favorable visual improvement. The preoperative visual acuity and symptom duration were a significant prognostic factor.

Two-Year Results of Intravitreal Bevacizumab Injection in Retinal Vein Occlusion

PURPOSE: The authors evaluated the 2-year clinical results of intravitreal bevacizumab injection in retinal vein occlusion (RVO). METHODS: Thirty-two eyes of 32 patients treated with an intravitreal bevacizumab injection of 1.25 mg (0.05 ml) for RVO (branch RVO: 22 eyes, central RVO: 10 eyes), repeated 3 times at a 6-week interval and were available for a follow-up period of at least 2 years were retrospectively reviewed. Best-corrected visual acuity (BCVA) before treatment and 6, 12, and 24 months after 3 serial injections, was recorded. The optical coherence tomography (OCT) results were analyzed to identify prognostic factors for recurrent macular edema that needed reinjection. RESULTS: Two years after the treatment, mean BCVA was significantly improved (p = 0.000). Out of 32 eyes, 16 (branch RVO: 8 eyes; central RVO: 8 eyes) needed reinjection because of recurrent macular edema. In central RVO, a significantly high reinjection rate was shown in serous retinal detachment (SRD) compared with cystoid macular edema (CME) as identified in OCT findings (p = 0.049). Additionally, in branch RVO, a high reinjection rate was shown in SRD, although statistically not significant (p = 0.375). CONCLUSIONS: In patients with RVO, a significant visual improvement was maintained for at least 2 years after intravitreal bevacizumab injection. Based on OCT results, SRD showed a high reinjection rate compared with CME in CRVO.

Exposure Assessment for Pesticide Residues in Vegetables using Korea National Health and Nutrition Examination Survey Data for Seoulites

The characteristics of pesticide residues were examined in 18,069 samples from 91 vegetable commodities collected in Seoul from 2007 to 2009, and the vegetable dietary intakes of Seoulites were estimated using the Korea National Health and Nutrition examination survey data from 2008. The hazard index was calculated using vegetable pesticide residues and dietary vegetable intake by Seoulites. Detection rates for pesticide residues in vegetables were 11.2 % in 2007, 8.6 % in 2008, and 12.0 % in 2009. Excess rate of Maximum Residue Limits tended to decline from 4.6 % in 2007, to 2.8 % in 2008, and 2.1 % in 2009. Daily vegetable intake for Seoulites was 288.12 +/- 214.8 g, and vegetable intake by males was more than that of females (p < 0.001). The hazard index was the highest at 2.76 x 10(-2) in 2007, and the lowest at 1.69 x 10(-2) in 2009. The risks caused by multiple pesticides in vegetables were very low and vegetable intake was safe considering the hazard index values.

Prevalence and Mechanisms of Low Level Quinolone Resistance among Non-Typhoidal Salmonella Isolates from Human and poultry/Livestock in Korea: Usefulness of Nalidixic Acid Resistance Test

BACKGROUND: Non-typhoidal Salmonella (NTS) are important commensal microorganisms. We intended to investigate the prevalence and mechanisms of nalidixic acid resistance among NTS isolated from human and poultry/livestock. METHODS: A total of 151 Salmonella isolates (36 human and 115 livestock isolates, respectively) was tested for the Minimum inhibitory concentrations (MICs) of nalidixic acid, together with serotyping. As for the nalidixic acid resistant isolates, further studies were taken: MICs of ciprofloxacin, mutation analysis of gyrA and parC genes, and organic solvent tolerance test. RESULTS: Eighty-four isolates of 151 human and livestock isolates were resistant to nalidixic acid. The prevalence of nalidixic acid resistance and was 13.9% (5 of 36 isolates) in human isolates and 68.7% (79 of 151 isolates), in the livestock isolates respectively. Among 84 nalidixic acid-resistant isolates, the The prevalence of ciprofloxacin resistance in livestock isolates was 24.1% (1 resistant and 18 intermediate of 79 strains), but no ciprofloxacin resistance was found in 5 human isolates. Among 65 nalidixic acid resistant, ciprofloxacin-susceptible isolates, 3 (60%, of 5 human isolates) and 60 (100%, all livestock isolates) showed low level fluoroquinolone resistance (ciprofloxacin MIC, 0.125-1.0 microgram/microliter). Six types of point mutations were found in the analysis of DNA sequencing of the gyrA gene in the 84 isolates; 75 isolates showed point mutations on amino acid Ser 83 and/or Asp 87. On the other hand, no point mutation was found from the parC genes. Forty-seven nalidixic acid resistant isolates showed tolerance to organic solvents. CONCLUSIONS: Nalidixic acid resistance was a good marker of low level fluoroquinolone resistance. As for the severe NTS infection, MIC test for nalidixic acid would be required.

Long-Term Results of Intravitreal Bevacizumab Injection for Macular Edema: Retinal Vein Obstruction and Diabetic Retinopathy

PURPOSE: To evaluate the long-term results of intravitreal bevacizumab injection for macular edema (ME) due to retinal vein obstruction (RVO) and diabetic retinopathy (DR). METHODS: The objects of study were patients with decreased visual acuity due to ME with RVO and DR for whom intravitreal injections of 1.25 mg (0.05 ml) bevacizumab were repeated three times with an interval of six weeks and who were available for a follow-up period of more than 12 months. The patients underwent additional bevacizumab injections if ME increased as assessed by optical coherence tomography (OCT). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline and follow-up visits. RESULTS: There were 16 patients with RVO and 18 patients with DR. In the RVO group, the mean length of follow-up was 12.4+/-1.1 months, the mean baseline BCVA was 0.75+/-0.32 and the final BCVA was 0.42+/-0.25, a difference that was statistically significant (p0.05). The mean CMT at baseline was 462.0+/-195.0 microm and decreased to a mean of 282.2+/-177.3 microm at the end of the follow-up period (p<0.05). CONCLUSIONS: In RVO and DR, three injections of intravitreal bevacizumab with an interval of six weeks and additional injections as indicated were effective in reducing ME and showed especially good results in improvement of visual acuity for ME due to RVO.

Comparison of Vitreolytic Effect in Rabbit Eyes: Plasmin, Hyaluronidase, and Their Mixtures

PURPOSE: The aim of the present study was to quantify and compare the vitreolytic effect of plasmin, hyaluronidase, and a combination of the two. METHODS: Thirty-six rabbits were randomized into 3 groups: (A) twelve rabbits had an intravitreal injection of plasmin 1 U with hyaluronidase 10 U/0.1 mL into the right eye, (B) twelve rabbits had an injection of plasmin alone (1 U/0.1 mL), and (C) twelve rabbits had an injection of hyaluronidase alone (10 U/0.1 mL). The left eye of each rabbit was used as control, which was injected with 0.1 mL phosphate buffered saline (PBS). The eyes were enucleated 1 hour and 24 hours after injection. The volume of fluid-type vitreous and gel-type vitreous was measured with a micropipette using the melting point as the difference. Statistical analysis was performed and light microscopy was used to assess potential damage to the retinal tissue. RESULTS: The volume of remaining gel-type vitreous was measured as 52.5%, 60.3%, 59.2%, and 76.5% after 1 hour enucleation and as 44.6%, 56.7%, 56.1%, and 74.7%, after 24 hours enucleation in group A, B, C, and control group, respectively. Group A, B, and C showed statistically significant differences against the control group. Group A (plasmin with hyaluronidase) showed less remaining gel-type vitreous volume than a single injection of plasmin or hyaluronidase alone. CONCLUSIONS: Intravitreal injection of plasmin with hyaluronidase showed more vitreolytic effect than a single injection of plasmin or hyaluronidase alone. The enzyme may be useful in liquefying the vitreous, and may be a useful biochemical adjunct to vitrectomy.

Surveillance of Acute Gastroenteritis in Seoul, Korea, During May 2004 and June 2007

Acute gastroenteritis (AGE), which is one of the most common diseases worldwide, primarily occurs in infants and young children in both developed and developing countries. To investigate the prevalence of AGE in Korea, 6,788 stool specimens collected from hospitalized patients with AGE in Seoul, Korea from March 2004 to June 2007 were analyzed by enzyme immunoassay, reverse transcription-PCR, DNA sequencing and phylogenetic analysis. Enteric viruses and bacteria were detected in 2,955 (43.5%) and 1,389 (20.5%) specimens, respectively. Among the enteric viruses detected, rotavirus (19.7%) and norovirus (18.9%) were the predominant causative agents, followed by adenovirus (2.5%) and astrovirus (2.4%). Staphylococcus aureus was the most commonly observed bacteria (8.0~19.2%). The epidemic peaks of the enteric viruses were October to December for norovirus, January to May for rotavirus, and August to October for adenovirus. The seasonal activity of rotavirus was shifted from winter to late spring. However, astrovirus did not display seasonal activity in this study. Although viral AGE primarily occurred in patients younger than 5 years of age, the incidence of viral AGE in children aged 6 to 14 years was significant. The results of this study will contribute to the currently available epidemiological data and improve public health and hygiene via amelioration of diagnostic methods and longitudinal surveillance.

Early and Late Intravitreal Bevacizumab Injection in Macular Edema Due to Branch Retinal Vein Occlusion

PURPOSE: To compare the effects of early and late intravitreal injection of bevacizumab in patients with macular edema (ME) due to branch retinal vein occlusion (BRVO). METHODS: The study sample included 56 eyes of 56 patients who received intravitreal bevacizumab injection for ME due to BRVO and were followed up with at least six months of observation. We retrospectively divided eyes into two classes that included 36 eyes with a disease duration of 3 months (late treatment group). We assessed the effects of injection on the best corrected visual acuity (BCVA), central retinal thickness and IOP at one, three, and six months after treatment. RESULTS: There was no statistically significant differences in terms of sex, age, number of injections, ischemia, pre-injection visual acuity and central retinal thickness between the two treatment groups. Improvements in central retinal thickness were observed in both groups but were not significantly different between the groups. Visual acuity improved in both groups after treatment; the improvement was significantly better in the early treatment group observed three and six months after treatment. IOP did not change after treatment in either group. CONCLUSIONS: In cases of ME due to BRVO, early intravitreal bevacizumab injection is more effective than late injection for maintaining and improving visual acuity.

Predictability of Donor Lamellar Graft Thickness and Diameter Using a Microkeratome in Porcine Eyes

PURPOSE: To evaluate the thickness and diameter of a lamellar graft with microkeratome and to determine its usefulness as a donor lamellar graft for microkeratome-assisted lamellar keratoplasty. METHODS: Thirty-six porcine eyes were randomly assigned to three groups according to the microkeratome (Automated Corneal Shaper(R)) depth plate: group 1 (#300 micrometer plate, 13 eyes), group 2 (#400 micrometer plate, 12 eyes), and group 3 (#450 micrometer plate, 11 eyes). Free corneal buttons were made with the corneal shaper after a uniform suction duration of 10 seconds. Central corneal thicknesses were measured with an automated ultrasound pachymeter prior to the procedure. After the lamellar graft was made, the remaining corneal thickness was measured with the same method. The difference between the two values was hypothesized to be the lamellar graft thickness. In addition, the diameter of lamellar graft was measured by calipers. RESULTS: The mean lamellar graft thicknesses in groups 1, 2, and 3 were 218.2+/-26.6 micrometer (72.7%), 312.3+/-26.7 micrometer (78.1%) and 345.7+/-36.7 micrometer (76.8%), respectively. There were no significant differences between the three groups according to the results brought by the microkeratome depth plates (p=0.239). The mean lamellar graft diameters in groups 1, 2, and 3 were 8.49+/-0.28 mm, 8.43+/-0.26 mm and 8.58+/-0.28 mm, respectively. There were no significant differences between the three groups (p=0.368). No relationship was found between lamellar graft thickness and diameter (r=-0.009, p=0.480). CONCLUSIONS: These results suggest that in forming donor lamellar grafts with microkeratome plates, thicker resection depth is needed because the actual lamellar graft were shown to be thinner than the target values. However, lamellar grafting is thought to be unsuitable for lamellar keratoplasty because it results in considerable thickness variability.

A Case Report of Human Thelaziasis

The authors report a case of infection with Thelazia callipaeda in a Korean man. The patient was a 47 year-old man. He experienced epiphora and foreign body sensation of the right eye since 3 weeks ago. Total of 2 worms were removed from the conjunctival sac; one by himself 1 day prior to examination and the other by an ophthalmologist. The worm was slender creamy white in color which was fixed in a 10% formaline solution. The worm was 17.38 mm in length, 0.45 mm in body width, 0.026 mm in length of buccal cavity, 0.63 mm in length of anterior end to vaginal opening, 0.76 mm in length of anterior end to the esophagointestinal junction and 0.06 mm in length of posterior end to the anus. There were numerous striations on surface of worms and vaginal opening was located anterior to the esophagointestinal junction. Based on aforementioned findings, it was confirmed as a female worm of Thelazia callipaeda, and the authors report it with literature.

A Case Report of Human Thelaziasis

The authors report a case of infection with Thelazia callipaeda in a Korean man. The patient was a 47 year-old man. He experienced epiphora and foreign body sensation of the right eye since 3 weeks ago. Total of 2 worms were removed from the conjunctival sac; one by himself 1 day prior to examination and the other by an ophthalmologist. The worm was slender creamy white in color which was fixed in a 10% formaline solution. The worm was 17.38 mm in length, 0.45 mm in body width, 0.026 mm in length of buccal cavity, 0.63 mm in length of anterior end to vaginal opening, 0.76 mm in length of anterior end to the esophagointestinal junction and 0.06 mm in length of posterior end to the anus. There were numerous striations on surface of worms and vaginal opening was located anterior to the esophagointestinal junction. Based on aforementioned findings, it was confirmed as a female worm of Thelazia callipaeda, and the authors report it with literature.

A Case of Bilateral Iris Cyst

PURPOSE: Iris cyst is a rare condition and there has been no Korean report of bilateral iris cyst. The authors present the first Korean report of a patient with bilateral iris cysts. METHODS: A 62-year-old man presented with intermittent visual field disturbance of the left eye when exposed to bright light. The patient underwent visual field examination and slit lamp examination. On slit lamp examination, a dark-brown mass was revealed along the lateral pupillary margin in the left eye. In the right eye, the shape of the iris was convex at the 8 o'clock direction. Ultrasound biomicroscopy, confirmed the presence of a mass. RESULTS: The patient showed no specific abnormality in visual field examination. Ultrasound biomicroscopy showed the objects to be cystic, with a thin-walled homogenous hypoechoic lesion on the posterior surface of the iris in both eyes. There were two cysts in each eye measuring 4.35 mm x 1.13 mm and 1.47 mm x 1.11 mm in the left eye, and 1.05 mm x 1.02 mm and 1.90 mm x 1.05 mm in the right eye. CONCLUSIONS: Asymptomatic iris cyst does not need to undergo treatment, but careful examination is nevertheless required required at regular intervals in case a complication develops.

Detection of Antibiotic Resistant Genes in Salmonella enterica Serovar Typhimurium Isolated from Foodborne Patients in Seoul Using Multiplex-PCR

The frequency of antibiotic resistance among Salmonella enterica serovar Typhimurium has increased due to the transfer of multiple resistance factors. We detected the 13 antibiotic resistance genes by multiplex-PCR and compared with the results of phage typing and antibiotic disk diffusion for 49 S. typhimurium isolated from food-poisoning outbreaks in Seoul from 1999 to 2002. Resistance genes for tetracycline, streptomycin, ampicillin, sulfonamide, amino-glycoside-modifying enzyme, chloramphenicol, kanamycin, and trimethoprim were detected in 67.3%, 57.1%, 26.5%, 8.1%, 8.1%, 5%, 2.0%, and 0% of isolates, respectively. Overall 28 isolates (57.1%) possessed two or more antibiotic resistance genes. Class 1 integron carrying multidrug resistace genes, ant(3")-IaB, blaPSE, qacE delta1/sul, and tet G were amplified especially in only DT104 isolates. Among the related resistance genes for same antibiotics, strA and strB for streptomycin resistance were simultaneously detected but tetA and tetB for tetracycline were sporadically detected. DT 104 isolates contained only aadA2 and tetG.