Validation of the OncoHepa test, a multigene expression profile test, and the tumor marker-volume score to predict postresection outcome in small solitary hepatocellular carcinomas

PURPOSE: OncoHepa test is a multigene expression profile test developed for assessment of hepatocellular carcinoma (HCC) prognosis. Multiplication of α-FP, des-γ-carboxy prothrombin (DCP) and tumor volume (TV) gives the α-FP-DCP-volume (ADV) score, which is also developed for assessment of HCC prognosis. METHODS: The predictive powers of OncoHepa test and ADV score were validated in 35 patients who underwent curative hepatic resection for naïve solitary HCCs ≤5 cm. RESULTS: Median tumor diameter was 3.0 cm. Tumor recurrence and patient survival rates were 28.6% and 100% at 1 year, 48.6% and 82.9% at 3 years, and 54.3% and 71.4% at 5 years, respectively. The site of first tumor recurrence was the remnant liver in 18, lung in 1, and the peritoneum in 1. All patients with HCC recurrence received locoregional treatment. OncoHepa test showed marginal prognostic significance for tumor recurrence and patient survival. ADV score at 4log also showed marginal prognostic difference with respect to tumor recurrence and patient survival. Combination of these 2 tests resulted in greater prognostic significance for both tumor recurrence (P = 0.046) and patient survival (P = 0.048). CONCLUSION: Both OncoHepa test and ADV score have considerably strong prognostic power, thus individual and combined findings of OncoHepa test and ADV score will be helpful to guide postresection surveillance in patients with solitary HCCs ≤5 cm.

Usefulness of neutrophil gelatinase-associated lipocalin(NGAL) to confirm subclinical acute kidney injury and renal prognosis in patients following surgery / 고신대학교의과대학학술지

OBJECTIVES: The neutrophil gelatinase-associated lipocalin (NGAL) level following non cardiac surgery is useful for predicting acute kidney damage. However, there is insufficient conclusive evidence as to whether NGAL can be used to predict subclinical AKI following non-cardiac surgery. METHODS: We measured serum NGAL and creatinine levels in 41 patients following non-cardiac surgery, and the increase of these variables was used to predict acute decreases in kidney function. RESULTS: The study included a total of 41 patients. The mean age was 64.65 ± 17.09 years. The serum creatinine concentration was increased 12 hours after surgery. The mean SD serum NGAL decreased after 4hours after surgery and continued to decrease after 12 hours after surgery. The incidence of subclinical AKI determined by the 4 hour serum NGAL level was 10(24.4%), and the incidence of serum creatinine elevation was 0(0.0%). The incidence of subclinical AKI determined by the 12 hour serum NGAL level was 4(9.8%), and the incidence of subclinical AKI determined by serum creatinine was 4(9.8%). The elevation of NGAL was more rapid than the serum creatinine 4 hours after surgery. CONCLUSIONS: We verified the usefulness of the serum NGAL level as a predictive factor for subclinical AKI after non-cardiac surgery.

Bioassay-Guided Isolation and Identification of Compounds from Arecae Pericarpium with Anti-inflammatory, Anti-oxidative, and Melanogenesis Inhibition Activities

This study describes the anti-inflammatory, anti-oxidant, and melanogenesis inhibition activities of methanol extract and various organic solvent fractions of Arecae Pericarpium. We examined the inhibition of lipopolysaccharide (LPS)-induced nitric oxide (NO) production in RAW 264.7 cells, 1,1-diphenyl-2-picrylhydrazine (DPPH) scavenging activity, mushroom tyrosinase inhibition activity and melanin contents. The study showed that, among all tested fractions, methylene chloride fraction showed the strongest inhibition of LPS-induced NO production in RAW 264.7 cells (IC₅₀ value 8.89 µg/mL) and DPPH radical scavenging activity (EC₅₀ value 21.39 µg/mL). Methylene chloride and ethyl acetate fractions similarly inhibited mushroom tyrosinase activity. Methanol extract exhibited strongest reduction of melanin content in B16F10 melanoma cells. Based on the bioactivity assay results, methylene chloride and ethyl acetate fractions were further separated. Eight phenolic compounds were isolated, which are dimeric syringol (1), catechol (2), 4-hydroxybenzaldehyde (3), vanillin (4), 4-hydroxyacetophenone (5), apocynin (6), protocatechuic acid (7) and 4-hydroxybenzoic acid (8). Among the isolated compounds tested, catechol showed the strongest inhibition of LPS-induced NO production in RAW 264.7 cells. Catechol also showed the concentration-dependent NF-κB inhibition activity. Arecae Pericarpium might have potentials to be developed as anti-inflammatory agent or dermatological product for skin-whitening agent.

Long-Term Effects of Bone Marrow-Derived Mesenchymal Stem Cells in Dextran Sulfate Sodium-Induced Murine Chronic Colitis

BACKGROUND/AIMS: Bone marrow-derived mesenchymal stem cells (BM-MSCs) have shown beneficial effects in experimental colitis models, but the underlying mechanisms are not fully understood. We investigated the long-term effects of BM-MSCs, particularly in mice with chronic colitis. METHODS: Chronic colitis was induced by administering 3% dextran sulfate sodium (DSS) in a series of three cycles. BM-MSCs were injected intravenously into DSS-treated mice three times during the first cycle. On day 33, the therapeutic effects were evaluated with clinicopathologic profiles and histological scoring. Inflammatory mediators were measured with real-time polymerase chain reaction. RESULTS: Systemic infusion of BM-MSCs ameliorated the severity of colitis, and body weight restoration was significantly promoted in the BM-MSC-treated mice. In addition, BM-MSC treatment showed a sustained beneficial effect throughout the three cycles. Microscopic examination revealed that the mice treated with BM-MSCs had fewer inflammatory infiltrates, a lesser extent of inflammation, and less crypt structure damage compared with mice with DSS-induced colitis. Anti-inflammatory cytokine levels of interleukin-10 were significantly increased in the inflamed colons of BM-MSC-treated mice compared with DSS-induced colitis mice. CONCLUSIONS: Systemic infusion of BM-MSCs at the onset of disease exerted preventive and rapid recovery effects, with long-term immunosuppressive action in mice with repeated DSS-induced chronic colitis.

Maternal antimullerian hormone as a predictor of fetal aneuploidy occurring in an early pregnancy loss

OBJECTIVE: The purpose of the study was to examine the relationship between the parameter representing ovarian reserve and the fetal aneuploidy in early spontaneous miscarriage. METHODS: A multicenter retrospective cohort study was performed in patients who were diagnosed with early pregnancy loss (< or =13 gestational weeks) and examined for fetal karyotype at the CHA Gangnam Medical Center, CHA Bundang Medical Center, and CHA Gumi Medical Center between January 2011 and December 2012. Karyotyping was performed by the Genetic Laboratory of the Fertility Center of CHA Gangnam Medical Center. Medical records were reviewed for demographics, karyotype analysis and hormonal assay of ovarian reserve including antimullerian hormone (AMH) and follicle stimulating hormone. Statistical analysis was performed using SPSS software. RESULTS: A total 462 patients were included in this study. The mean age of the patients was 35.31+/-4.12 years and the mean AMH level was 3.88+/-3.50 ng/mL (n=195). Two hundred eleven conceptuses (45.7%) of patients showed the euploid and 251 (54.3%) showed the aneuploid. There are significant differences in maternal age, AMH and gestational age between fetal euploid and aneuploid groups (34.46+/-4.35 vs. 36.04+/-3.78 years, P<0.001; 4.60+/-3.86 vs. 3.43+/-3.18 ng/mL, P=0.022; 7.67+/-1.54 vs. 8.27+/-1.46 weeks, P<0.001, respectively). Multivariate analysis revealed that low AMH level and early gestational age were maternal age-independent markers for fetal aneuploid (P<0.001 and P=0.045, respectively). CONCLUSION: Low maternal AMH level might be a predicting marker for fetal aneuploid in early pregnancy loss.

Predictors of the Development of Significant Tricuspid Regurgitation after Permanent Pacemaker Implantation / 대한내과학회지

BACKGROUND/AIMS: We sought to identify predictors of significant tricuspid regurgitation (TR) after successful permanent pacemaker (PPM) implantation in Korean patients. METHODS: Of 404 patients who underwent PPM implantation, 187 patients who had both baseline and follow-up echocardiographic examinations were assigned to one of two groups: no development or change in TR (Group I, n = 172, 65.5 +/- 13.7 years) versus the development of significant TR (Group II, n = 15, 72.1 +/- 8.3 years). Clinical, laboratory, and echocardiographic variables were compared between the two groups. RESULTS: Overall, the grade of TR was significantly aggravated from 0.46 +/- 0.73 to 0.81 +/- 0.84 (p < 0.001) during 3.1 +/- 1.8 years of follow-up (0.49 +/- 0.75 to 0.69 +/- 0.74 in Group I, p < 0.001; 0.13 +/- 0.35 to 2.27 +/- 0.46 in Group II, p < 0.001). The de novo development or aggravation of TR was observed in 66 patients (35.3%), and significant TR developed in 15 patients (8.0%). The presence of atrial fibrillation (AF) was significantly higher (53.3 vs. 18.6%, p = 0.002), and the implantation of a ventricle pacing, ventricle sensing, inhibited by ventricular event (VVI) type pacemaker was more frequent in Group II than in Group I (46.7 vs. 15.1%, p = 0.002). Other variables were not different between the groups. CONCLUSIONS: The development or aggravation of TR was not rare after successful PPM implantation, even though the development of significant TR was uncommon. The presence of AF and the implantation of a VVI type pacemaker were predictors of the development of significant TR. Together, the results of this study suggest that the development or aggravation of TR should be monitored carefully after PPM implantation.

Lemierre Syndrome Caused by Arcanobacterium haemolyticum Alone in a Healthy Man / 전남의대학술지

Arcanobacterium haemolyticum was isolated from the blood cultures of a previously healthy 37-year-old man who met all the criteria of Lemierre syndrome, including a primary oropharyngeal infection, evidence of thrombophlebitis of the internal jugular vein, and metastatic infections. To the best of our knowledge, this is the first case of Lemierre syndrome caused by A. haemolyticum in Korea and shows that A. haemolyticum alone can cause Lemierre syndrome.

Lemierre Syndrome Caused by Arcanobacterium haemolyticum Alone in a Healthy Man / 전남의대학술지

Arcanobacterium haemolyticum was isolated from the blood cultures of a previously healthy 37-year-old man who met all the criteria of Lemierre syndrome, including a primary oropharyngeal infection, evidence of thrombophlebitis of the internal jugular vein, and metastatic infections. To the best of our knowledge, this is the first case of Lemierre syndrome caused by A. haemolyticum in Korea and shows that A. haemolyticum alone can cause Lemierre syndrome.

Successful Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction in a Patient with Dextrocardia and Hypertrophic Cardiomyopathy

We report a case of a 69-year-old man presenting with acute right chest pain radiating to the right shoulder. Physical examination revealed a right sided apex beat with a palpable liver on the left side. Reversed normalizing electrocardiogram are presented, allowing for correct diagnosis of an acute anterior myocardial infarction. Dextrocardia with situs inversus is an uncommon congenital condition, the patient also diagnosed hypertrophic cardiomyopathy by two dimensional echocardiography. Successful percutaneous coronary intervention was performed and the patient was discharged after uneventful recovery.

Differing Electrophysiological Effects of Various Antiarrhythmic Drugs on the Cardiac Chamber in Atrial Fibrillation / 대한내과학회지

BACKGROUND/AIMS: Long-term antiarrhythmic drug therapy remains the principal approach for suppressing atrial fibrillation (AF) and maintaining sinus rhythm. In this study, we examined the differing electrophysiological effects of various antiarrhythmic drugs on the cardiac chamber and atrial selectivity in patients with AF. METHODS: We analyzed 134 patients (60.4 +/- 12.5 years, M:F = 1.14:1) who were administered a single antiarrhythmic agent for AF over 6 months: amiodarone (group A), flecainide (group F), or propafenone (group P). The P wave, QRS complex duration and dispersion, and QT interval and its dispersion were evaluated using a standard 12-lead electrocardiogram. RESULTS: There was no significant difference in age, gender ratio, or associated diseases among the three groups. In group A, Pmax, Pmin, P dispersion, QRSmax, QRSmin, and QRS dispersion were shorter than in groups F and P, whereas Pmax/QRSmax was the highest in group A (A = 1.2, F = 0.9, P = 1.0; p < 0.01). QTcmax and QTcmin were longer in group A, whereas QTc dispersion and the QT peak to end (A = 13.3 +/- 11.2, F = 30.7 +/- 24.9, P = 31.8 +/- 21.6; p < 0.01) were shorter in group A than in the other groups. CONCLUSIONS: Amiodarone had a weaker, but more selective, inhibitory effect on intra-atrial conduction, and inhibited ventricular repolarization more effectively and homogenously than flecainide or propafenone. These differing electrophysiological effects may contribute to the superior effectiveness and safety of amiodarone over flecainide or propafenone.

Human Cord Blood Stem Cell Therapy for Treatment of Stress Urinary Incontinence

Our objective in this study was to evaluate the safety and efficacy of transurethral cord blood stem cell injection for treatment of stress urinary incontinence in women. Between July 2005 and July 2006, 39 women underwent transurethral umbilical cord blood stem cell injection performed by one operator at a single hospital. All patients had stress urinary incontinence. The patients were evaluated 1, 3, and 12 months postoperatively. No postoperative complications were observed. 28 patients (77.8%) were more than 50% satisfied according to the Patient's Satisfaction results after 1 month, 29 patients (83%) were more than 50% satisfied according to the Patient's Satisfaction results after 3 months, and 26 (72.2%) continuously showed more than 50% improvement after 12 months. Intrinsic sphincter deficiency and mixed stress incontinency improved in the ten patients evaluated by urodynamic study. Our results suggest that transurethral umbilical cord blood stem cell injection is an effective treatment for women with all types of stress urinary incontinence.

The Efficacy and Safety of Inflatable Obstetric Belts for Management of the Second Stage of Labor

This study was designed to assess the effect of inflatable obstetric belts on uterine fundal pressure in the management of the second stage of labor. One hundred twenty-three nulliparas with a singleton cephalic pregnancy at term were randomized. Standard care was performed in the control group, and uterine fundal pressure by the Labor Assister(TM) (Baidy M-420/Curexo, Inc., Seoul, Korea) was utilized in addition to standard care in the active group. The Labor Assister(TM) is an inflatable obstetric belts that synchronized to apply uniform fundal pressure during a uterine contraction. The 62 women in the active group spent less time in the second stage of labor when compared to the 61 women in the control group (41.55+/-30.39 min vs. 62.11+/-35.99 min). There was no significant difference in perinatal outcomes between the two groups. In conclusion, the uterine fundal pressure exerted by the Labor Assistertrade mark reduces the duration of the second stage of labor without attendant complications.

Effect of Direct Revascularization in Ischemic Type of Adult Moyamoya Disease / 대한뇌혈관외과학회지

OBJECTIVE: The authors evaluated the effects of direct revascularization (superficial temporal artery-middle cerebral artery bypass) in the prevention of further stroke, including recurrent ischemic event or bleeding in patients with ischemic type of adult moyamoya disease by clinical, pathophysiological and angiographical studies. MATERIALS AND METHODS: Twenty four patients who had ischemic symptoms in adult moyamoya disease were investigated. The mean age of the patients was 40.8 years. The follow up period ranged from 6 months to 8 years. In 24 patients who were surgically treated, thirty one sides (both sides in 7 patients) were performed to superficial temporal artery-middle cerebral artery anastomosis and dura splitting. RESULT: Average follow up period was 4.12 years. Perioperative and postoperative course was uneventful in 16 patients. 2 patients had new ischemic attack probably due to intracerebral steal phenomenon during operation, 6 patients had neurologic symptoms due to change of hemodynamic flow pattern after successful EC-IC bypass that included temporary neurologic deficit in 4, postbypass occlusion of the preoperative stenosis of anterior cerebral artery in one and focal seizure in one. Long term follow up results of 24 patients were showing major deficit in one and minor deficit in two. All patients experienced no further ischemic or hemorrhagic events during follow up period. In postoperative angiogram, drastic diminution of basal moyamoya vessels, which are supposed to be responsible for hemorrhage, was observed in 15 of 18 patients(83%) who were capable of postoperative 3-6 months follow up angiogram. CONCLUSION: In case of adult moyamoya disease, direct bypass surgery is particularly important on the prevention of recurrent ischemic or hemorrhagic events. And a decrease in basal moyamoya vessels was induced significantly by direct bypass surgery, which may reduce the expected risk of hemorrhage effectively. But direct bypass in moyamoya disease had operative morbidity in high frequence. So, moyamoya disease patients who undergo direct revascularization should be monitored carefully during the perioperative and postoperative period.

CD36 signaling inhibits the translation of heat shock protein 70 induced by oxidized low density lipoprotein through activation of peroxisome proliferators-activated receptor gamma

Oxidized LDL (OxLDL), a causal factor in atherosclerosis, induces the expression of heat shock proteins (Hsp) in a variety of cells. In this study, we investigated the role of CD36, an OxLDL receptor, and peroxisome proliferator-activated receptor gamma (PPAR gamma) in OxLDL-induced Hsp70 expression. Overexpression of dominant-negative forms of CD36 or knockdown of CD36 by siRNA transfection increased OxLDL-induced Hsp70 protein expression in human monocytic U937 cells, suggesting that CD36 signaling inhibits Hsp70 expression. Similar results were obtained by the inhibition of PPAR gamma activity or knockdown of PPAR gamma expression. In contrast, overexpression of CD36, which is induced by treatment of MCF-7 cells with troglitazone, decreased Hsp70 protein expression induced by OxLDL. Interestingly, activation of PPAR gamma through a synthetic ligand, ciglitazone or troglitazone, decreased the expression levels of Hsp70 protein in OxLDL-treated U937 cells. However, major changes in Hsp70 mRNA levels were not observed. Cycloheximide studies demonstrate that troglitazone attenuates Hsp70 translation but not Hsp70 protein stability. PPAR gamma siRNA transfection reversed the inhibitory effects of troglitazone on Hsp70 translation. These results suggest that CD36 signaling may inhibit stress- induced gene expression by suppressing translation via activation of PPAR gamma in monocytes. These findings reveal a new molecular basis for the anti-inflammatory effects of PPAR gamma.

Prenatal Diagnosis and Clinical Outcome of Fetal Ovarian Cysts / 대한주산의학회잡지

PURPOSE:The purpose of this study is to evaluate the ultrasonographic finding and clinical course of fetal ovarian cysts. METHODS:A retrospective study of 11 cases of fetal ovarian cysts, evaluated by prenatal and postnatal ultrasonographic studies was conducted. We analyzed the demographic factors, the ultrasonographic findings, the change of ultrasonographic parameters, the mode of delivery, the management of ovarian cysts and pathologic finding. RESULTS:In all cases, fetal ovarian cysts were unilateral simple cysts at the time of diagnosis. The mean sizes of the ovarian cysts were 29.7 mm on prenatal and 19.8 mm on postnatal studies. In four of the 11 cases, the ultrasonographic patterns of cysts changed from simple to complicated cysts on serial monitorng, and one of them required postnatal surgery. Ten of 11 cases were spontaneously resolved during perinatal follow-up ultrasound. CONCLUSION:We recommend continuous ultrasonographic assessment of antenatally diagnosed ovarian cysts, which is helpful to predict the outcome of cysts and decide on the management.

Effect of Direct Bypass on the Prevention of Hemorrhage in Patients with the Hemorrhagic Type of Moyamoya Disease / 대한뇌혈관외과학회지

OBJECTIVE: The authors evaluated the effect of direct bypass (superficial temporal artery-middle cerebral artery bypass) in the prevention of rebleeding episodes in patients suffering from hemorrhagic moyamoya disease by comparing this method with indirect bypass. METHODS: Fifteen patients who had hemorrhagic moyamoya without aneurysm comprised the study group. The mean age of patients was 44.4 years and follow up period ranged from 0.8 to 7.1 years (mean; 3.61 years). Revascularization surgery was performed in 21 sides in 15 patients. Direct bypass was performed in 17 sides and indirect bypass in the other 4 sides. RESULTS: During the follow-up period after the revascularization surgery, three sides (14.3%) of the 21 sides presented with rebleeding episode, one of 17 sides (mean follow-up periods; 2.94 years) treated with direct method and 2 of 4 sides (mean follow-up periods; 6.45 years) treated with indirect method. Kaplan-Meier analysis of rebleedingfree survival showed quite different between direct and indirect method but statistically insignificant (p=0.0541). CONCLUSION: Direct bypass may reduce the risk of hemorrhage more effectively than indirect bypass. However, direct bypass cannot always prevent rebleeding.

Rapid prenatal diagnosis of Down syndrome and Edward syndrome by fluorescence In situ hybridization:Clinical experience with 309 cases

PURPOSE: The purpose of this study was to evaluate the clinical utility of rapid detection of Down syndrome and Edward syndrome by Interphase Fluorescence in Situ Hybridization (FISH) analysis METHODS: A retrospective study in 309 cases of amniotic fluid samples, analysed by interphase FISH with DNA probes specific to chromosome 18 and 21, was performed. All FISH results were compared with conventional cytogenetic karyotypings. RESULTS: The results were considered as informative and they were obtained within 48 hrs. A case of Down syndrome and a case of Edward syndrome were diagnosed by FISH and confirmed by subsequent cytogenetic analysis. In 12 cases with normal FISH results, the cytogenetic analysis showed a case of partial trisomy 22, three cases of sex chromosomal aneuploidy, two cases of mosaicism, two cases of microdeletion, and four cases of structural rearrangement. CONCLUSION: FISH is a rapid and effective diagnostic method, which can be used as an adjunctive test to cytogenetic analysis, for prenatal identification of chromosome aneuploidies. For the more genome- wide screening with variety of probes, the technique of FISH is both expensive and labor-intensive.

Pregnancy outcomes in women aged 35 and older / 대한산부인과학회지

OBJECTIVE: To estimate the effect of maternal age on obstetric outcomes, a retrospective analysis was done. METHODS: Twenty six hundred and forty six women who delivered a singleton baby at our hospital from January 1, to December 31, 2004 were enrolled in this study. Subjects were divided into 3 age groups; 1) less than 35 years, 2) 35-39 years, and 3) 40 years and older. Chi-square test was used to assess the effect of age on obstetrics outcome. Then the odds ratio was calculated to represent clinically meaningful risk. RESULTS: A total of 2646 women with complete data were available; 2245 (84.9%) less than 35 years of age; 350 (13.2%) 35-39 years; and 51 (1.9%) 40 years and older. Increasing age was significantly associated with chromosomal abnormalities (OR 3.9and 8.8 for ages 35-39 years and age 40 years and older, respectively), Preterm premature rupture of membranes (OR 1.3 and 3.2) and cesarean delivery (OR 2.0 and 5.5). Patients aged 35-39 years were at increased risk for placenta previa (OR 1.8) and congenital anomaly (OR 2.8) but these were not statistically significant. The rate of the preterm delivery was increased by age (OR 1.3 and 1.9 for ages 35-39 years and age 40 years and older, respectively) but it was not statistically significant (p=0.121). We did not find advanced maternal age to be associated with a statistically increased risk for preeclampsia, congenital anomaly, gestational diabetes, placenta abruption, low birth weight, macrosomia, neonatal morbidity (NICU admission), and perinatal loss. CONCLUSION: In conclusion, although the likelihood of adverse outcomes increases with maternal age, patients and obstetric care providers can be reassured that overall maternal and fetal outcomes are favorable in this patient population.

Development of a Medical Ontology Library: Analysis of the Clinical Terms in the Medical Records of a COPD Patient / 대한의료정보학회지

OBJECTIVE: The medical records of a patient with chronic obstructive pulmonary disease(COPD) were analyzed to extract medical concepts and their relationships in order to construct a basic medical ontology. METHODS: The medical records included the admission note, vital signs record, doctors' order sheets, progress notes, emergency notes, discharge summary, surgical record, and anesthesia record. RESULTS: A total of 396 concepts, 16 relationships, and 460 connections were created. Fourteen top-level concepts, such as body, sign, and procedure, were found. The most common relationship was 'isA' and the second was 'isPartOf'. All the relationships between the concepts were displayed using the graphic tool GraphViz. CONCLUSION: A pilot ontology on COPD was constructed through a medical record analysis. The asynchronous cooperation using a web interface for the ontology construction was helpful.

Evaluation for Patterns of the Maternal Weight changes and the Twin Weight Discordance Changes during whole Pregnant Periods / 대한주산의학회잡지

OBJECTIVES: To evaluate the patterns of changes in maternal weight and fetal weight discordance in twin pregnancies during consecutive gestational periods. METHODS: A retrospective chart review was done for a total of 148 twin pregnancies taken care of throughout pregnancies between February 2002 and May 2004. They were divided into two groups; group A consisting of 109 cases without postnatal complications and with no more than 25% twin weight discordance at birth, and group B consisting of 39 cases with more than 25% twin weight discordance. Both ultrasound examination and maternal weight measurement were conducted in the three gestational intervals; between prepregnant times to gestational age 18 weeks, between gestational ages 18 to 28 weeks, and from gestational age 28 weeks to delivery. RESULTS: Except for maternal weights, none of the pregnancy factors such as maternal age, parity, gravity, height, prepregnant weight, duration of pregnancy, natural or artificial pregnant status, gender and chorionicity showed any significant difference by means between the two groups. The maternal BMI of the group A vs. the group B at the first, the second, and the third period were 0.53+/-0.10% and 2.01+/-1.28%, 2.97+/-0.11% and 4.84+/-1.23%, and 3.29+/-0.16% and 2.15+/-0.63% respectively. Inter-twin weight discordances between the two groups were 8.29+/-0.67% vs. 11.26+/-1.25 %, 7.79+/-0.05% vs. 11.03+/-1.36%, and 9.07+/-0.55% vs. 32.79+/-1.13%, respectively. CONCLUSIONS: Although several factors that affect twin weight discordance may be considered, we showed that the pattern of maternal weight gain during the gestational period is associated with the estimated values of twin weight discordances in the first gestational period.