How much have the perinatal outcomes of triplet pregnancies improved over the last two decades?

OBJECTIVE: This study was conducted to demonstrate the temporal trends in perinatal outcomes of triplet pregnancies over the last two decades. METHODS: The medical records of patients with triplet pregnancies at two Korean tertiary-care hospitals from 1992 to 2012 were retrospectively reviewed in regard to maternal and neonatal outcomes. The study was divided into two periods for analysis: period I (1992–2001) and period II (2003–2012). RESULTS: Over a 21-year period, 65 women with triplet pregnancies and 185 neonates were analyzed. Period II, when compared with period I, was associated with improved maternal outcomes, characterized by a decreased incidence of preeclampsia (31.8% vs. 2.3%, P=0.002) and anemia (68.2% vs. 30.2%, P=0.003) during pregnancy. Regarding neonatal aspects, the composite morbidity of period II was significantly decreased compared with that of period I, as assessed with a generalized estimating equation for logistic regression (26.2% vs. 8.1%, P=0.03). Multivariable analysis revealed that the gestational age at delivery and the period were significantly associated with the composite neonatal morbidity (P<0.001 and 0.007, respectively). CONCLUSION: Improved neonatal morbidity was associated with a higher gestational age at delivery and with the more recent decade.

Content based medical image retrieval based on new efficient local neighborhood wavelet feature descriptor

This paper presents a new class of local neighborhood based wavelet feature descriptor (LNWFD) for content based medical image retrieval (CBMIR). To retrieve images effectively from large medical databases is backbone of diagnosis. Existing wavelet transform based medical image retrieval methods suffer from high length feature vector with confined retrieval performance. Triplet half-band filter bank (THFB) enhanced the properties of wavelet filters using three kernels. The influence of THFB has employed in the proposed method. First, triplet half-band filter bank (THFB) is used for single level wavelet decomposition to obtain four sub-bands. Next, the relationship among wavelet coefficients is exploited at each sub-band using 3 × 3 neighborhood window to form LNWFD pattern. The novelty of the proposed descriptor lies in exploring relation between wavelet transform values of pixels rather than intensity values which gives more detail local information in wavelet sub-bands. Thus, proposed feature descriptor is robust against illumination. Manhattan distance is used to compute similarity between query feature vector and feature vector of database. The proposed method is tested for medical image retrieval using OASIS-MRI, NEMA-CT, and Emphysema-CT databases. The average retrieval precisions achieved are 71.45%, 99.51% of OASIS-MRI and NEMA-CT databases for top ten matches considered respectively and 55.51% of Emphysema-CT database for top 50 matches. The superiority in terms of performance of the proposed method is confirmed by the experimental results over the well-known existing descriptors.

Secular Trends of Multiple Birth Rate in Korea: 1981–2017

PURPOSE: To determine the secular trend of the multiple birth rate in Korea from 1981 to 2017. METHODS: This study used birth certificate data covering the years 1981–2017 (20,948,901 births), provided by Statistics Korea. The impact of assisted reproductive technologies (ART) on multiple birth was analyzed by examining data prior to and after the introduction of ART and the national support program for infertile couples in South Korea. The odds ratio (OR) and 95% confidence intervals were calculated to describe the secular trend in the multiple birth rate per 100 births. RESULTS: During this period, the multiple birth rate per 100 births increased by 277 percent from 1.031 to 3.891, the twin birth rate increased from 1.013 to 3.807 (275%), and the triplet birth rate increased from 0.018 to 0.084 (363%). The secular trend of the multiple birth rate remained in the 1.000 level during 1981–1991, but has been rising steadily since 1992. The average increment of the multiple birth rate was 3.9% annually from 1981 through 2017 (peaking at more than 10 percent during 2006–2007). Prior to the introduction of ART in Korea (1981–1984), the multiple birth rate was 1.007, but after its introduction, the multiple birth rate was 1.005 in 1985–1989 (OR, 0.998; 95% confidence interval, 0.982–1.014), 1.084 in 1990–1994 (1.007; 1.060–1.094), 1.891 in 2000–2004 (1.894; 1.866–1.922), 3.127 in 2010–2014 (3.173; 3.129–3.217), and 3.811 in 2015–2017 (3.893; 3.835–3.952). CONCLUSION: Over the past three decades, multiple births have risen dramatically in Korea, primarily due to the increasingly widespread use of fertility therapies, and the delayed age of childbearing. There is a need for more research to understand the factors contributing to multiple births, and the national birth registration systems ought to be reformed to monitor whether multiple births originated spontaneously or from assisted-conception.

Amor materno e cuidado profissional / Maternal love and professional care / Amor materno y cuidado profesional

Este artigo visa trazer uma reflexão acerca dos cuidados profissionais direcionados à primeira infância, especialmente os cuidados oferecidos por babás, tão comum no contexto brasileiro. Primeiramente, foi proposta uma discussão acerca da importância do cuidado para o desenvolvimento emocional do bebê, bem como as distinções existentes entre as relações que a cuidadora estabelece com o bebê, daquela estabelecida entre a díade mãe-bebê. Partindo dessas considerações, um estudo de caso foi apresentado. Este foi realizado com uma mãe e seus três bebês trigêmeos, acompanhados por uma observadora durante os dois primeiros anos de vida dos bebês através do método Bick de observação de bebês.

This article aims at bringing a reflection about the professional early childhood care, especially the nannies, so common in the Brazilian context. First, a discussion was proposed about the importance of care for the emotional development of the baby, as well as the distinction between the relationship the caregiver establishes with the baby and that established between the mother and baby. From these considerations, a case study was presented, referring to a mother and her three triplet babies, accompanied by an observer during the first two years of the babies' life, through the Bick method of infant observation.

Este artículo pretende reflexionar sobre los cuidados profesionales dirigidos a la primera infancia, especialmente de las niñeras, muy común en el contexto brasileño. Se propone una discusión acerca de la importancia de los cuidados en el desarrollo emocional del bebé, así como las distinciones existentes entre las relaciones que la cuidadora establece con el bebé y las relaciones madre-bebé. Desde estas consideraciones, se realizó un estudio de caso con una madre y sus tres bebés trillizos, acompañados por una observadora durante los dos primeros años de vida de los bebés a través del método Bick de observación de bebés.

A relação mãe e filho: vicissitudes de um (des)encontro para o laço simbólico / Mother-baby relationship: vicissitudes of the (dis)encounter for symbolic ties / La relación madre-bebé: vicisitudes de (des)encuentro para el lazo simbólico

A clínica da intervenção precoce nos convoca a refletir acerca da função materna no processo de construção do enlace com o Outro primordial e de como é possível ao analista intervir no (des)encontro mãe e filho, visando ao estabelecimento ou ao restabelecimento do circuito pulsional. Alguns bebês deparam com dificuldades para alcançar o estatuto de Sua Majestade, o Bebê, como dizia Freud. Qual será a situação em casos de trigêmeos? A partir da exposição de um caso clínico, pretendemos discutir as questões do laço simbólico entre mãe e bebê.

The clinic of child early intervention invites us to think about the mother's function as part of the construction of the ties with the Primordial Other and about how the analyst can intervene in the (dis)encounter between mother and child, aiming at the establishment or the re-establishment of the pulsion. Some babies are struggling to reach the status of His Majesty, the Baby, as Freud would say. How would it be in cases of triplets? Through the presentation of a clinical case, we intend to discuss the issues of the symbolic ties between mother and baby.

La clínica de la intervención precoz nos convoca a reflexionar sobre la función materna en el proceso de construcción del enlace con el Otro primordial y de cómo es posible la intervención del analista en el (des)encuentro madre e hijo, con el fin de establecer o de restablecer el circuito pulsional. Algunos bebés encuentran dificultades para alcanzar el estatuto de "Su Majestad, el Bebé", como decía Freud. ¿Cuál será la situación en caso de trillizos? A partir de la exposición de un caso clínico, pretendemos discutir las cuestiones del lazo simbólico entre madre y bebé.

Combinatorial Antitumor Activity of Oxaliplatin with Epigenetic Modifying Agents, 5-Aza-CdR and FK228, in Human Gastric Cancer Cells

Epigenetic silencing is considered to be a major mechanism for loss of activity in tumor suppressors. Reversal of epigenetic silencing by using inhibitors of DNA methyltransferase (DNMT) or histone deacetylases (HDACs) such as 5-Aza-CdR and FK228 has shown to enhance cytotoxic activities of several anticancer agents. This study aims to assess the combinatorial effects of gene-silencing reversal agents (5-Aza-CdR and FK228) and oxaliplatin in gastric cancer cells, i.e., Epstein-Barr virus (EBV)-negative SNU-638 and EBV-positive SNU-719 cells. The doublet combinatorial treatment of 5-Aza-CdR and FK228 exhibited synergistic effects in both cell lines, and this was further corroborated by Zta expression induction in SNU-719 cells. Three drug combinations as 5-Aza-CdR/FK228 followed by oxaliplatin, however, resulted in antagonistic effects in both cell lines. Simultaneous treatment with FK228 and oxaliplatin induced synergistic and additive effects in SNU-638 and SNU-719 cells, respectively. Three drug combinations as 5-Aza-CdR prior to FK228/oxaliplatin, however, again resulted in antagonistic effects in both cell lines. This work demonstrated that efficacy of doublet synergistic combination using DNMT or HDACs inhibitors can be compromised by adding the third drug in pre- or post-treatment approach in gastric cancer cells. This implies that the development of clinical trial protocols for triplet combinations using gene-silencing reversal agents should be carefully evaluated in light of their potential antagonistic effects.

Multicenter Phase II Study of Oxaliplatin, Irinotecan, and S-1 as First-line Treatment for Patients with Recurrent or Metastatic Biliary Tract Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Although gemcitabine plus cisplatin has been established as the standard first-line chemotherapy for patients with advanced biliary tract cancer (BTC), overall prognosis remains poor. We investigated the efficacy of a novel triplet combination of oxaliplatin, irinotecan, and S-1 (OIS) for advanced BTC. MATERIALS AND METHODS: Chemotherapy-naive patientswith histologically documented unresectable or metastatic BTC were eligible for this multicenter, single-arm phase II study. Patients received 65 mg/m2 oxaliplatin (day 1), 135 mg/m2 irinotecan (day 1), and 40 mg/m2 S-1 (twice a day, days 1-7) every 2 weeks. Primary endpoint was objective response rate. Targeted exome sequencing for biomarker analysis was performed using archival tissue. RESULTS: In total, 32 patients were enrolled between October 2015 and June 2016. Median age was 64 years (range, 40 to 76 years), with 24 (75%) male patients; 97% patients had metastatic or recurrent disease. Response rate was 50%, and median progression-free survival and overall survival (OS) were 6.8 months (95% confidence interval [CI], 4.8 to 8.8) and 12.5 months (95% CI, 7.0 to 18.0), respectively. The most common grade 3-4 adverse events were neutropenia (32%), diarrhea (6%), and peripheral neuropathy (6%). TP53 and KRAS mutations were the most frequent genomic alterations (42% and 32%, respectively), and KRAS mutations showed a marginal relationship with worse OS (p=0.07). CONCLUSION: OIS combination chemotherapy was feasible and associated with favorable efficacy outcomes as a first-line treatment in patients with advanced BTC. Randomized studies are needed to compare OIS with gemcitabine plus cisplatin.

The Association between Adequate Prenatal Care and Severe Maternal Morbidity: A Population-based Cohort Study

PURPOSE: This study identified the relationship between adequate prenatal care and severe maternal morbidity among delivered women. METHODS: Data were extracted from the Korean National Health Insurance Service-National Sample Cohort for 91,767 cases of delivery that were delivered during 2003~2013. Severe maternal morbidity status was determined using the Center for Disease Control and Prevention's algorithm including the diagnosis and procedure code during delivery and postpartum hospitalization. A generalized estimating equation (GEE) model with log link was performed for the relationship with severe maternal morbidity and women's factors to estimate adjusted relative risk. RESULTS: Of the 91,767 delivery cases, 2,248 (2.45%) had severe maternal morbidity. In the GEE model, severe maternal morbidity was higher in women who had inadequate prenatal care than in those who had adequate prenatal care (relative risk (RR) 1.39, 95% CI 1.11~1.75, p-value 0.0045). For maternal age, women who delivered at extremely young or old ages had high risks of severe maternal morbidity, which showed a U-shaped distribution through the whole age range. Women who had the lowest level of income, who had cesarean section delivery, who were nulliparous, who had twins or more than triplet births had high risks of severe maternal morbidity. CONCLUSION: Inadequate prenatal care delivery was associated with the occurrence of severe maternal morbidity. Therefore, policy makers should consider making quality indicators for early, timely, and sufficient visits during pregnancy and should monitor adequacy of prenatal care to prevent severe maternal morbidity.

Length of First Birth Interval and Incidence of Twin Birth in Korea; 2010~2015

PURPOSE: To compare the incidence of twin births with the length of first birth interval (LFBI: from marriage to first birth) among primiparous women. METHODS: The birth certificated data of Korea Statistics from 2010 to 2015 were used for this analysis. There were 1,356,204 births of primiparous women from total birth cases (2,736,296 births). The data involving multiparous women, teenage birth, extra-marital birth, and triplet birth cases were excluded from all analyses. Odds ratio and 95 percent confidence intervals were calculated from logistic regression to examine the risk of twin birth by LFBI adjusted for year of birth, maternal age, paternal age, age difference between couples, and maternal education and occupation. RESULTS: The frequency of LFBI was 41.5 percent in ≤12 months, 30.7 percent in 13~24 months, 13.1 percent in 25~36 months, and 2.1 percent in LFBI of ≥85 months. The mean LFBI was 21.5 months. The incidence of twin birth increased with prolonged LFBI. The twin birth rates per LFBI were 0.8 percent, 3.1 percent, 7.9 percent, and 11.0 percent in LFBI of ≤12 months, 25~36 months, 49~60 months, and 73~84 months, respectively. Odds ratio of twin births rate by LFBI were 1.510 (95% confidence interval: 1.449~1.574) for the LFBI of 13~24 months, 9.839 (9.390~10.309) for 49~60 months, and 13.244 (12.458~14.080) for ≥73~84 months, each compared with LFBI of ≤12 months. Odds ratio of twin birth rate in LFBI of ≤72 months was higher in women aged 35 and older, as compared to women aged ≤34 years. Odds ratio of twin birth rate by maternal age (≤34 years versus ≥35 years) reversed in LFBI of ≥73 months. CONCLUSION: The risk of twin birth increased significantly with prolonged LFBI. There is a need to understand the factors (fertility therapy and etc.) to increased risk of twin birth in prolonged LFBI.

Clinical Outcome of Doublet and Triplet Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer / 대한소화기학회지

BACKGROUND/AIMS: In gastric cancer, the rate of recurrence and metastasis following radical resection is high, necessitating improvement in survival and cure rates. Neoadjuvant chemotherapy (NAC) has potential benefits for locally advanced gastric cancer; however, the surgical benefits and effects on survival are unclear. This study evaluates the effectiveness of NAC in locally advanced gastric cancer and compares clinical outcomes of doublet and triplet regimens. METHODS: We reviewed patient medical records of 383 patients who underwent NAC (n=41) or surgery only (n=342) for treatment of locally advanced gastric cancer. The baseline characteristics and clinical outcomes were compared between the groups. Chemotherapy patients were classified according to regimen, doublet (n=28) and triplet (n=13), and NAC-related clinical response, safety, and toxicity were analyzed. RESULTS: The baseline characteristics did not differ significantly between groups. After NAC, the tumor downstage rate was 51.2% (21/41); however, overall survival (p=0.205) and disease-free survival (p=0.415) were not significantly different between the groups. On subgroup analysis, no significant differences in drug toxicity (p=0.604) or clinical response (p=0.374) were found between outcomes of doublet and triplet chemotherapy regimens. CONCLUSIONS: In patients with locally advanced gastric cancer, NAC showed tolerable drug toxicity and increased tumor downstage, but NAC failed to increase the survival rate, which may be caused by a high D2-lymphadenectomy rate. Therefore, NAC was found to be a therapeutic option for select gastric cancer patients.

Bilateral Adduction Palsy in a Patient with Myotonic Dystrophy Type 1

Myotonic dystrophy type 1 (DM1) is caused by CTG repeat expansion in the DMPK gene in chromosome 19q13.3. External ophthalmoplegia is a rare manifestation in DM1. We report a DM1 patient confirmed by the presence of 650 CTG triplet expansions in the DMPK gene and had limitation of adduction gaze bilaterally. Brain MRI showed bilateral medial rectus muscles atrophy. Our patient provides additional evidence of ocular motor muscle involvement in DM1.

MicroRNA-183 Family in Inner Ear: Hair Cell Development and Deafness

miRNAs are essential factors of an extensively conserved post-transcriptional process controlling gene expression at mRNA level. Varoius biological processes such as growth and differentiation are regulated by miRNAs. Web of Science and PubMed databases were searched using the Endnote software for the publications about the role miRNA-183 family in inner ear: hair cell development and deafness published from 2000 to 2016. A triplet of these miRNAs particularly the miR-183 family is highly expressed in vertebrate hair cells, as with some of the peripheral neurosensory cells. Point mutations in one member of this family, miR-96, underlie DFNA50 autosomal deafness in humans and lead to abnormal hair cell development and survival in mice. In zebrafish, overexpression of the miR-183 family induces extra and ectopic hair cells, while knockdown decreases the number of hair cell. The miR-183 family (miR-183, miR-96 and miR-182) is expressed abundantly in some types of sensory cell in the eye, nose and inner ear. In the inner ear, mechanosensory hair cells have a robust expression level. Despite much similarity of these miRs sequences, small differences lead to distinct targeting of messenger RNAs targets. In the near future, miRNAs are likely to be explored as potential therapeutic agents to repair or regenerate hair cells, cell reprogramming and regenerative medicine applications in animal models because they can simultaneously down-regulate dozens or even hundreds of transcripts.

Secular Trends of Gestational Length Distribution in Korean Singleton and Twin Birth: 1997~99, 2011~13

PURPOSE: To compare the secular trends of gestational length distribution in singleton and twin birth by analyzing the birth certificated data of Statistics Korea. METHODS: The birth certificated data of Statistics Korea was used for this analysis (1997~99: 1,850,236 births, 2011~13: 1,325,301 births). The data of triplet birth cases, extra-marital birth, non-hospital birth cases, teenage birth, and gestational length information missing cases were excluded. Odds ratio and 95% confidence intervals were calculated from multinomial logistic regression analyses to describe the secular trend (1997~99 and 2011~13) of early preterm birth rate (≤33 weeks), late preterm birth rate (34~36 weeks), term birth rate (37~41 weeks), and post-term birth rate (≥42 weeks) adjusted for maternal age (20, 25, 30, 35, 40), birth order (1st=1, 2nd=2, ≧3rd=3), infantile gender (male=1, female=0), maternal occupation (none=1, yes=0), and education (≤middle=1, high=2, college/university=3). RESULTS: From phase I (1997~99) to phase II (2011~13), the gestational length distribution in singleton and twin births shifted the left and toward shorter gestational distribution, and mean gestational length decreased from 39.4 weeks to 38.7 weeks in singleton birth, and decreased from 36.9 weeks to 35.7 weeks in twin birth, During the period, the term birth rate of singleton birth was unchanged at 95 percent, but the term birth rate of twin birth was decreased from 65.7 percent to 46.1 percent. The odds ratio of early preterm birth, late preterm birth, term birth rate, and post-term birth rate in singleton birth for phase II were, respectively, 1.138 (95% confidence interval: 1.106~1.171), 1.556 (1.532~1.581), 1.094 (1.081~1.107), and 0.113 (0.109~0.118), compared with rate of each gestational length for phase I. The odds ratio of each gestational length in twin birth of phase II, comparing phase I, were 1.495 (1.405~1.590) for early preterm birth, 2.110 (2.029~2.194) for late preterm birth, 0.444 (0.428~0.461) for full term birth, and 0.055 (0.026-0.117) for post-term birth. CONCLUSION: The risk of early preterm birth, late preterm birth between phase I & II increased higher in twin birth than that of singleton birth. The rise in early and late preterm birth, and decrease in mean gestational length in singleton and twin birth during the period. There was a need to more research in this area to understand the contributing factors to gestational length.

Anomalías dentales de número: Supernumerarios en trillizos. Revisión de tema y reporte de casos / Number dental anomalies: Supernumerary in triplets. Literature review and case report

Los dientes supernumerarios son conside- rados como una de las anomalías dentales donde hay un desarrollo y/o formación de un mayor número de dientes. Estos pue- den encontrarse aislados, o asociados a un síndrome, pudiendo causar complicaciones en la erupción, la oclusión y la estética. Aunque la etiología de los supernumerarios no es plenamente conocida, algunos autores hacen mención de teorías como la dicoto - mía del germen dentario, hiperactividad de la lámina dental, y alteraciones genéticas, donde se han encontrado asociaciones con patrones de herencia autosómica dominan - te, autosómica recesiva o herencia ligada al cromosoma X. Teniendo en cuenta la importancia genética en la aparición de supernumerarios es posible pensar que en el caso de compartir la misma infor - mación, si se presenta una alteración en la formula dental, esta se debería repetir en sus hermanos. De acuerdo a este punto de vista con una perspectiva genetista este artículo presenta la situación de tres trillizos tricigóticos que presentan alteración en su fórmula dental de una forma indistinta en cuanto a dentición afectada (decidua y/o permanente) posición en el arco (derecha o izquierda) y diente afectado.

Supernumerary teeth are considered as one of the dental anomalies where there is a development and / or training of a larger number of teeth. These may be isolated or associated with a syndrome, which can cause complications in the eruption, occlusion and a esthetics. Although the etiology of supernumerary is unknown, some authors make mention of theories as the dichotomy of tooth germ, hyperactivity of the dental lamina and genetic alterations, with matching patterns partnerships with autosomal dominant or autosomal recessive inheritance linked to X chromosome. Given the genetic importance in the development of supernumerary it is conceivable that in the case of sharing the same information, if a disturbance occurs in the dental formula, this should be repeated in his brothers. According to this view with a geneticist perspective this paper presents the situa- tion of three triplets tricigoticos presenting alteration in a dental formula in terms inter - changeably affected dentition (decidua and / or permanent) position on the bow (right or left) and impacted tooth.

Embarazo triple monocorial triamniótico: experiencia de dos casos y revisión de la literatura / Triamniótico triple monochorionic pregnancy: experience of two cases and literature review

Los embarazos múltiples se consideran una entidad de alto riesgo obstétrico. Su incidencia ha ido en aumento debido a la utilización de técnicas de reproducción asistida y el aumento de la edad materna. Se presentan 2 casos de embarazos triples monocoriales triamnióticos, de sexo femenino y masculino. En ambos embarazos se manifestaron complicaciones, principalmente fetales y neonatales, atribuidas a embarazos múltiples descritas en la literatura.

Multiple pregnancies are considered a high-risk obstetric entity. Their incidence has been increasing due to the use of assisted reproductive techniques and increased maternal age. Here, we describe two cases of triamniotic monochorionic triplet pregnancies, female and male respectively. Both pregnancies demonstrated complications, mainly fetal and neonatal, attributed to multiple pregnancies reported in the literature.

Implementation of a Next-Generation Electronic Nursing Records System Based on Detailed Clinical Models and Integration of Clinical Practice Guidelines / 대한의료정보학회지

OBJECTIVES: The purpose of this paper is to describe the components of a next-generation electronic nursing records system ensuring full semantic interoperability and integrating evidence into the nursing records system. METHODS: A next-generation electronic nursing records system based on detailed clinical models and clinical practice guidelines was developed at Seoul National University Bundang Hospital in 2013. This system has two components, a terminology server and a nursing documentation system. RESULTS: The terminology server manages nursing narratives generated from entity-attribute-value triplets of detailed clinical models using a natural language generation system. The nursing documentation system provides nurses with a set of nursing narratives arranged around the recommendations extracted from clinical practice guidelines. CONCLUSIONS: An electronic nursing records system based on detailed clinical models and clinical practice guidelines was successfully implemented in a hospital in Korea. The next-generation electronic nursing records system can support nursing practice and nursing documentation, which in turn will improve data quality.

Comparative Evaluation of Intron Prediction Methods and Detection of Plant Genome Annotation Using Intron Length Distributions

Intron prediction is an important problem of the constantly updated genome annotation. Using two model plant (rice and Arabidopsis) genomes, we compared two well-known intron prediction tools: the Blast-Like Alignment Tool (BLAT) and Sim4cc. The results showed that each of the tools had its own advantages and disadvantages. BLAT predicted more than 99% introns of whole genomic introns with a small number of false-positive introns. Sim4cc was successful at finding the correct introns with a false-negative rate of 1.02% to 4.85%, and it needed a longer run time than BLAT. Further, we evaluated the intron information of 10 complete plant genomes. As non-coding sequences, intron lengths are not limited by a triplet codon frame; so, intron lengths have three phases: a multiple of three bases (3n), a multiple of three bases plus one (3n + 1), and a multiple of three bases plus two (3n + 2). It was widely accepted that the percentages of the 3n, 3n + 1, and 3n + 2 introns were quite similar in genomes. Our studies showed that 80% (8/10) of species were similar in terms of the number of three phases. The percentages of 3n introns in Ostreococcus lucimarinus was excessive (47.7%), while in Ostreococcus tauri, it was deficient (29.1%). This discrepancy could have been the result of errors in intron prediction. It is suggested that a three-phase evaluation is a fast and effective method of detecting intron annotation problems.

Radiofrequency Catheter Ablation for Unifocal Premature Ventricular Complexes Triggering Recurrent Ventricular Fibrillations in a Young Man Without Structural Heart Disease

A 17-year-old man was referred for aborted sudden cardiac death. Ventricular fibrillation (VF) was recorded by automated external defibrillator. Post-resuscitation electrocardiograms showed frequent monomorphic premature ventricular complexes (PVCs), with left bundle branch block configuration and inferior axis. Cardiac arrest due to VF recurred twice within the initial 42 hours. Rhythm monitoring revealed multiple episodes of sustained VF triggered by a triplet of monomorphic PVCs having similar morphology with isolated PVCs. Comprehensive cardiologic workup revealed no structural heart disease and ion-channelopathies. With the impression of idiopathic VF triggered by unifocal PVCs of right ventricular outflow tract (RVOT) origin, radiofrequency catheter ablation was performed to prevent frequent VF recurrence before implantable cardioverter-defibrillator (ICD) implantation. After successful ablation of the origin of unifocal PVCs at anterolateral wall of RVOT, the burden of PVCs decreased remarkably and VF did not recur. The patient was discharged after ICD implantation.

Trillizos y adicciones / Triplets and adictions

En diversos estudios científicos se ha verificado que la adicción, así como otros trastornos psiquiátricos, está influenciada por la carga genética heredada. Así mismo, se postula la presencia de brotes psicóticos en relación al consumo de marihuana y se describe una elevada tasa de comorbilidad de otros trastornos psiquiátricos en pacientes adictos. Presentamos a tres hermanos trillizos que desarrollaron adicción a marihuana, esquizofrenia, trastorno obsesivo-compulsivo, depresión, dismorfofobia y conducta disocial. El factor genético y el ambiental contribuirían a la activación de genes adictivos heredados, a la transición del uso al abuso, a la adicción a sustancias psicoactivas y a la activación de genes relacionados a otros trastornos psiquiátricos comórbidos.

In scientific studies it has been verified that the addiction, as well as other psychiatric disorders, is influenced by the inherited genetic burden. It is also postulated the presence of psychotic outbreaks in relation to the use of marijuana and a high rate of comorbidity of other psychiatric disorders in addicted patients was described. We present three triplets who developed addiction to marijuana, schizophrenia, obsessive-compulsive disorder, depression, dysmorphophobia and antisocial behavior. Environmental and genetic factors would contribute to the activation of genes inherited addictive, to the transition from use to abuse and addiction to psychoactive substances, and to the activation of genes related to other comorbid psychiatric disorders.

Parto tras la transferencia de embriones generados por fecundación de ovocitos vitrificados: Comunicación de un caso / Live birth after the transfer of embryos obtained by fertilization of vitrified oocytes: Report of one case

We report the first successful live birth after the transfer of embryos obtained by fertilization of vitrified oocytes. A couple with primary infertility due to teratozoospermy and chronic an ovulation decided to undergo assisted reproductive technology after 4 failed cycles of super ovulation and intrauterine insemination. The woman underwent a standard luteal phase agonist protocol, with controlled ovarian hyper stimulation with daily 150IU recombinant gonadotropin and 75IU urinary gonadotropin for 12 days. Due to the high risk of ovarian hyper stimulation syndrome the couple was advised to delay embryo transfer. Eighteen mature oocytes were recovered, eight were vitrified and 10 fertilized and cryopreserved as pro-nuclei. Two months later, four vitrified oocytes were thawed, and three morphologically-normal embryos were transferred to an estrogen-progesterone-primed uterus, obtaining triple clinical pregnancy. The pregnancy was uneventful until 32 weeks of amenorrhea, when pre-term delivery started. After inducing lung maturity, a cesarean section was performed and three healthy fetuses were delivered. Nowadays, the babies are two and a half years old, and have had a normal psycho-motor development.