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Little is known about longitudinal changes of the first twin presentation in twin gestations. This is a retrospective cohort study including 411 women who were admitted consecutively and delivered live-born twins at 36 weeks of gestation or more. Longitudinal assessment of the first twin presentation was conducted during gestation and at birth in all cases. Gestational age at antenatal assessment was divided into two intervals: early-third trimester (28–31 weeks) and mid-third trimester (32–35 weeks). Fetal presentation was categorized as vertex or non-vertex. We analyzed change of fetal presentation between antepartum intervals and birth. First twin presentation at early-third trimester had the same presentation at birth in 87.6% (360/411) of the study population. In this ‘no change’ group, vertex presentation was seen in 95.6% (283/296) and non-vertex was seen in 67.0% (77/115) of cases. In total, 96.1% (395/411) of the study population maintained their presentation between mid-third trimester and birth. Vertex presentation was seen in 98.4% (310/315) and non-vertex was seen in 88.5% (85/96) of cases. When comparing vertex with non-vertex, vertex presentation during third trimester was a more reliable predictor of presentation at birth (p < .001). The only factor that contributed significantly to spontaneous version of the first twin during mid-third trimester and birth was a lower birth weight of the first twin compared with the second twin. In conclusion, first twin presentation with vertex during third trimester is not likely to change into non-vertex at birth. We concluded that vertex presentation in twin gestations at early- and mid-third trimester is very predictable. In contrast, a non-vertex first twin presentation is relatively unstable.
The objective of the present study was to determine whether angiotensinogen G(–6)A polymorphism is associated with the elevation of blood pressure (BP) in the hypertensive disorders of pregnancy in Korean population. The subjects included 201 cases with the hypertensive disorders of pregnancy and 160 healthy controls. The medical records of subjects were reviewed. Cases were classified into the four subtypes (transient hypertension, preeclampsia, chronic hypertension, and preeclampsia superimposed on chronic hypertension) by the diagnostic criteria suggested by the National High Blood Pressure Education Program Working Group. Cases were also divided into the high and low BP group by the elevation of BP (diastolic BP greater than or equal to 110 mmHg). Maternal angiotensinogen G(–6)A polymorphism was determined by restriction fragment length polymorphism. Frequencies of AA genotype were significantly higher in the high than in the low BP group in the preeclampsia, superimposed preeclampsia, and the combined group (N = 201), suggesting that the angiotensinogen G(–6)A allele was significantly associated with the elevation of BP in the hypertensive disorders of pregnancy among South Korean women. The present findings imply that the elevation of BP can serve as an endophenotype for a spectrum of hypertensive conditions in pregnancy.
Birthweight has implications for physical and mental health in later life. Using data from Caucasian twins collected in Australia, the Netherlands and the United States, and from East Asian twins collected in Japan and South Korea, we compared the total phenotypic, genetic and environmental variances of birthweight between Caucasians and East Asians. Model-fitting analyses yielded four major findings. First, for both males and females, the total phenotypic variances of birthweight were about 45% larger in Caucasians than in East Asians. The larger phenotypic variances were mainly attributable to a greater shared environmental variance of birth- weight in Caucasians (ranging from 62% to 67% of variance) than Asians (48% to 53%). Second, the genetic variance of birthweight was equal in Caucasians and East Asians for both males and females, explaining a maximum of 17% of variance. Third, small variations in total phenotypic variances of birthweight within Caucasians and within East Asians were mainly due to differences in nonshared environmental variances. We speculate that maternal effects (both genetic and environmental) explain the large shared environmental variance in birthweight and may account for the differences in phenotypic variance in birthweight between Caucasians and East Asians. Recent molecular findings and specific environmental factors that are subsumed by maternal effects are discussed.
Background: Although the clinical importance of chorionicity in twin pregnancies has been studied widely, the significance of perinatal determination of zygosity using molecular genetic analyses remains controversial. The purpose of this study was to determine the frequency and clinical significance of twin gestations according to zygosity and chorionicity in a Korean population. Methods: We enrolled 569 women who delivered twin newborns (> 24 weeks) at Seoul National University Hospital between 1999 and 2008. Chorionicity was established by histologic examination of placentae. Zygosity was determined with sex of neonates, chorionicity, and DNA analysis of umbilical cord blood. Results: The frequency of dizygotic (DZ) twins was 71.0% (404/569 pairs) based on the opposite sex (238/404 [58.9%]) and DNA analyses (166/404 [41.1%]); that of monozygotic (MZ) twins was 29.0% (165/569), including monochorionic (MC) (72.1% [119/165]) and dichorionic (DC) twins (27.9% [46/165]), which was confirmed by DNA analyses. Among spontaneously conceived twins, the frequency of MZ twins was more than twice that of DZ twins. The risk of low birth weight was 1.8-fold higher among MZDC twins and 1.9-fold higher among MZMC twins than among DZDC twins (p < .05). Bronchopulmonary dysplasia occurred more frequently among MZMC twins than among DZDC twins (adjusted OR 8.42, 95% CI 1.82–39.08, p < .01). However, the frequencies of other neonatal morbidities were not significantly higher in the MZMC group than in the MZDC and DZDC groups. The perinatal mortality rate was 15 per 1000 total births in the DZDC twins, 20 per 1000 total births in the MZDC and 56 per 1000 total births in the MZMC (p < .01). Conclusions: Although monozygosity was shown to be a risk factor for perinatal death and accurate determination of zygosity plays a great role in the future consideration of organ transplantation and twin studies, the value of zygosity determination along with chorionicity in relation to overall neonatal morbidity was not definite.
The electrical properties of Ni-based ohmic contacts N-face p-type GaN are presented. The specific contact resistance of N-face p-GaN exhibits a liner decrease from 1.01 × cm2 to 9.05 × 10-3 Ω cm2 for the as-deposited and the annealed Ni/Au contacts, respectively, with increasing annealing temperature Furthermore, the specific contact resistance could be decreased by four orders of magnitude to 1.03 × 10-4 Ω cm2 as a result of surface treatment using an alcohol-based (NH4)2S solution. The depth profile data measured by the intensity of O1s core peak in the x-ray photoemission spectra showed that the alcohol-based (NH4)2S treatment was effective in removing of the surface oxide layer of GaN. In addition, a Ga 2p core-level peak showed a red-shift of binding energy by 0.3 eV by alcohol-based (NH4)2S treatment, indicating that the surface Fermi level was shifted toward the valence-band edge. Thus, the low ohmic contact behavior observed in our treated sample might be explained in terms of the removal of the oxide layer and reducing the barrier heights by reduced band-bending effect.
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