Septal Rupture During Early Pregnancy and Successful Delivery in Monozygotic Dichorionic Diamniotic Twin After a Single Blastocyst Transfer.

The frequency of twins resulting from a single embryo transfer has been reported to be 1.56%, with the majority being monochorionic. We present a case of septal rupture at 8 weeks of gestation and successful delivery at 36 weeks of gestation of a monozygotic dichorionic diamniotic twin after a single blastocyst transfer. This report could partially clarify the pathogenesis of monozygotic twins and septal disruption. A 37-year-old woman with 9 months of primary infertility was referred to our department. After seven cycles of artificial insemination, she underwent her first in vitro fertilization. Ten cumulous-oocyte complexes were retrieved, of which three were fertilized, and three blastocysts were cryopreserved. The first single blastocyst transfer in a hormone replacement cycle resulted in a dichorionic diamniotic twin pregnancy. Transvaginal ultrasound at 7 weeks and 4 days gestation revealed a size difference in the gestational sacs and a disruption of the inter-amniotic membrane between the two gestational sacs at 8 weeks and 6 days. Both fetuses were seen in the larger gestational sac; however, the umbilical cord of the migrated fetus was from the original gestational sac. Both fetuses developed without discordancy or obvious anomalies. At 36 weeks and 6 days of gestation, the patient underwent cesarean delivery, resulting in the birth of two viable male infants without any congenital anomalies (weighing 2256 g and 2456 g). Two amniotic cavities existed; however, no chorionic villi were present. There have been many reports on septal disruption in monochorionic diamniotic twins; however, only two cases of dichorionic diamniotic twins have been reported. Furthermore, the onsets in both reports were after the second trimester of pregnancy. This report presents the first case of septal disruption in dichorionic diamniotic twins during the first trimester.

Early menopause and a low body mass index are associated with an increased risk of coronary heart disease in Japanese women.

OBJECTIVE: The primary objective was to investigate the association between early menopause and cardiovascular disease (CVD) prevalence in Japanese women. The secondary objective was to ascertain the association with CVD risk factors. METHODS: In this cross-sectional study, 7,239 naturally menopausal women from the Yamagata Cohort Study who completed an annual health visit and questionnaire between 2009 and 2015 were divided into three groups according to their age at menopause (women experiencing menopause at <45, 45-49 y, and ≥ 50 y). The diagnosis of coronary heart disease (CHD) and stroke were made by self-report, while hypertension, hyperlipidemia, and diabetes mellitus, were diagnosed by vital signs and laboratory parameters. Logistic regression analysis was used to estimate the associations between age at menopause and CVD prevalence and CVD risk factors. RESULTS: A total of 354 (4.9%) and 156 (2.2%) women reported a history of CHD and stroke, respectively. Women experiencing menopause at <45 years had a higher prevalence of CHD than those experiencing menopause at ≥50 years (OR 1.77, 95% CI 1.07-2.90; P = 0.023). Stroke, hypertension, diabetes mellitus, and hyperlipidemia were equally prevalent among the three groups. Significant interactions were observed between age at menopause and body mass index (BMI) (P = 0.025) and parity (P = 0.025). Among those with a BMI < 18.5 or parity ≥2, women experiencing menopause at <45 years had a significantly higher prevalence of CHD than those experiencing menopause at ≥50 years. CONCLUSION: Early menopause and low BMI were associated with CHD in Japanese women.

Role of multiple HLR1 sequences in the regulation of the dual promoters of the psaAB genes in Synechocystis sp. PCC 6803.

Previously, we analyzed the promoter architecture of the psaAB genes encoding reaction center subunits of photosystem I (PSI) in the cyanobacterium Synechocystis sp. PCC 6803. There exist two promoters, P1 and P2, both of which show typical high-light (HL) response of PSI genes; their activities are high under low-light (LL) conditions but rapidly downregulated upon the shift to HL conditions. In this study, it was suggested that a response regulator RpaB binds to multiple high-light regulatory 1 (HLR1) sequences in the upstream region of the psaAB genes. We explored the regulatory role of cis-elements, including these HLR1 sequences on the individual activity of P1 and P2. Under LL conditions, the most influential cis-element is HLR1C (-62 to -45, relative to the transcriptional starting point of P1) working for positive regulation of P1. The other HLR1 sequences also affect the promoter activity under LL conditions; HLR1A (-255 to -238) is involved in repression of P1, whereas HLR1B (-153 to -126) works for activation of P2. Upon the shift to HL conditions, regulation via HNE2 located within the region from -271 to -177 becomes active in order to downregulate both P1 and P2 activities. A positive effect of HLR1B on P2 may persist under HL. These results suggest that cis-elements, including multiple HLR1 sequences, differently regulate the activities of dual promoters of the psaAB genes to achieve the fine-tuning of the gene expression.