Maternal serum alpha-fetoprotein(MSAFP) has been a world wide screening test for open neural the tube defect. But elevation of MSAFP is related to not only neural tube defect, but also incorrect gestational age, congenital anomalies such as congenital nephrosis, esophageal and intestinal obstruction, low birth weight, oligohydroamnios, fetal death and chromosomal anomalies. If MSAFP is elevated, gestational age, congenital anomalies such as neural tube defect, multiple pregnancy and fetal death must be evaluated by ultrasound. When the ultrasound is nondiagnostic, amniotic fluid AFP(AFAFP) levels are measured and if AFAFP is elevated, presence or absence of aetylchoineststarase(AChE) is determined to rule out the false positive of amniotic AFP. Amniotic AChE test yielded detection rate of open spina bifida of 99%, 98% for anecephaly and a false-positive rate of 0.34%. We report a case with elevated AFAFP and positive amniotic AChE result in one fetus of the twin pregnancy conceived by ICSI and ZIFT, but in which targeted ultrasound findings were normal, maintained the pregnancy to term and normal twin was delivered by elective cesarean section.
Acetylcholinesterase ; alpha-Fetoproteins ; Amniotic Fluid* ; Cesarean Section ; Female ; Fetal Death ; Fetus* ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intestinal Obstruction ; Mass Screening ; Nephrosis ; Neural Tube Defects ; Pregnancy ; Pregnancy, Multiple ; Pregnancy, Twin* ; Sperm Injections, Intracytoplasmic* ; Spina Bifida Cystica ; Ultrasonography ; Zygote Intrafallopian Transfer ; Zygote*

No abstract available.
Asian Continental Ancestry Group* ; Humans

No abstract available.
Asian Continental Ancestry Group* ; Humans

BACKGROUND: Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. METHODS: All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. RESULTS: A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (I), 22.9%; Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (I 20.6%, R 71.4%) followed by Sri Lanka (I 71.4%, R 14.3%), Hong Kong (I 24.1%, R 76%) and Korea (I 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (I 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIC90s for ciprofloxacin were 4 microgram/mL (Hong Kong) and 2 microgram/mL (11 Asian countries except Hong Kong), respectively. CONCLUSION: Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.
Anti-Infective Agents ; Asia ; Asian Continental Ancestry Group* ; China ; Ciprofloxacin ; Erythromycin ; Hong Kong ; Humans ; Immune Sera ; Korea ; Malaysia ; Penicillin Resistance ; Penicillins ; Prevalence ; Prospective Studies ; Serotyping ; Sri Lanka ; Streptococcus pneumoniae ; Taiwan ; Vietnam

BACKGROUND: Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. METHODS: All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. RESULTS: A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (I), 22.9%; Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (I 20.6%, R 71.4%) followed by Sri Lanka (I 71.4%, R 14.3%), Hong Kong (I 24.1%, R 76%) and Korea (I 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (I 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIC90s for ciprofloxacin were 4 microgram/mL (Hong Kong) and 2 microgram/mL (11 Asian countries except Hong Kong), respectively. CONCLUSION: Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.
Anti-Infective Agents ; Asia ; Asian Continental Ancestry Group* ; China ; Ciprofloxacin ; Erythromycin ; Hong Kong ; Humans ; Immune Sera ; Korea ; Malaysia ; Penicillin Resistance ; Penicillins ; Prevalence ; Prospective Studies ; Serotyping ; Sri Lanka ; Streptococcus pneumoniae ; Taiwan ; Vietnam