Applying newly devised model, heritability (VA/VP) of plasma uric acid level, corrected for age and sex and standardized, was estimated at 0.8 in families consisting of twin parents, spouses and children. Correlation between spouses due to common genotype (ρ) was approximately 0.1, and variance due to common familial environment (VEC/Vp) was -0.3. Analysis of families of selected twin children and their parents resulted in two estimates of heritability: approximately 0.7 and 0.3, ρ being 0.34 and 0.04, and VEC/Vp being 0.04 and 0.34, respectively. Regression of IQ (y) on corrected and standardized plasma uric acid level (x) in the twin children was y = 5.56x + 123, correlation being 0.334 (p < 0.025). The result indicates a genetic basis of blood uric acid level, which may have resulted from polymorphisms in purine metabolism pathway, end product of which is uric acid in man. The significant correlation between plasma uric acid level and IQ suggests a contribution of partly common gene loci to the two quantitative traits.

Twelve pairs of MZ and 7 of DZ normal adult male twins were given a challenge dose of 0.8 mg ethanol per kg body weight diluted to a 30% v/v solution. Measures of blood alcohol, mood, craving for alcohol, body sway, heart rate and four psychomotor tasks were taken before, during and after intoxication. Genetic factors were found to be involved in the response of heart rate, body sway and two of the psychomotor tasks, but not in changes in blood alcohol, alertness or craving for alcohol. Drinking habits did not exert a strong influence upon acute responses to alcohol, but were significantly related to craving for alcohol whilst intoxicated.

Selective feticide by fetoscopic air embolism was carried out in six twin pregnancies complicated by discordance for a severe abnormality. In three, a previous diagnostic fetoscopy had been performed. The procedure was effective and uncomplicated in all cases. One patient is undelivered and five have delivered healthy babies, three at term and two preterm. One of the latter, delivered at 28 weeks, died of complications in the neonatal period.

It is shown that sex- and age-specific death rates from all causes of death other than neoplasms have features that resemble those of corresponding rates for all neoplasms. The same generalization holds in connexion with specific neoplastic and non-neoplastic disorders. In both categories of disease many age-patterns suggest that the rate-governing mechanism for their occurrence is stochastic in character; a rather small number of random events, generally fewer than ten, suffice for their initiation. It is not immediately obvious how a widespread degenerative disorder, sometimes involving an astronomical number of target cells, can be initiated by only a few random events. We infer that all such disorders, together with natural cancers, are autoaggressive in nature. They are initiated by random somatic mutations in comparator stem cells of the central system of growth control. Mutant stem cells propagate forbidden clones of cells that attack target cells at one or multiple sites. (In certain disorders, the presence of an extrinsic precipitator in the host in essential to the propagation of forbidden clones). Autoaggressive attacks have consequences that range from the destruction of target cells to their transformation with invasive proliferation. Senescence can be regarded as the cumulative effect of predominantly late-onset autoaggressive disorders. The relevance of studies of twins to this unified theory is discussed.

A preliminary analysis of twins or triplets with heart defects, ascertained in five centres, confirms earlier suggestions that monozygotic (MZ) twins are over represented among twins with heart defects, even after excluding persistent ductus arteriosus and conjoined twins. An MZ twin individual has a risk of cardiovascular malformation approximately twice that of DZ twins and singletons. It is suggested that the twinning process itself affects one of the pair. Disturbance of laterality (‘mirror imaging’) is probably a more important mechanism than twin-twin transfusion. Inappropriate use of the twin method in the past has caused the importance of genetic factors in the etiology of congenital heart defects to be underestimated. Neverthless, twins do provide a useful illustration of the likely importance of epigenetic factors in heart development.

A sample of twins separated early in life has been identified in the Swedish Twin Registry. When the registry was compiled in 1961 (old cohort) and 1973 (young cohort), one or both members of 961 pairs indicated that they were separated by the age of 10. In May 1979, both members of 698 pairs were alive and were sent a questionnaire concerning the circumstances of separation. Items included reasons and timing of separation, biological relatedness of rearing parents, degree of contact after separation (including whether they lived in the same area, attended the same school, or lived together again), rough measures of selective placement, and current frequency of contact. An attempt was then made to categorize the pairs based on degree of separation. A total of 257 pairs met the criteria: rearing parents of one twin biologically unrelated to rearing parents of the cotwin, twins not living together again after separation, and contact after separation a few times a year or less. As much as 50% were separated by their first birthday, and 80% by the age of five. Various data from the twin registry are presented describing the entire sample of early separated twins as compared to a matched sample of twins reared together.

Fasting blood glucose and serum immunoreactive insulin (IRI) and the responses of blood glucose and serum IRI to peroral glucose challenge were investigated in middle-aged normoglycemic male twins of 17 monozygotic (MZ) and 18 dizygotic (DZ) pairs recruited from the Finnish Twin Cohort Study. Also, the role of obesity and diet in the regulation of glucose and insulin metabolism was estimated. The fasting and 2 hr postprandial (PP) glucose showed higher pairwise correlations in MZ (r =0.78 and 0.56) than DZ (r = 0.08 and −0.05) pairs whereas fasting and PP insulin levels and the areas under the PP glucose and insulin curves were weakly and similarly correlated in MZ and DZ twins. The pairwise correlations of the 1/2 hr and 1 hr, but not the fasting and 2 hr insulin/glucose ratios, were somewhat higher in MZ (R = 0.51 and 0.53) than DZ (r = = 0.28 and 0.30) pairs. In MZ twins, the intrapair differences in the body mass index were significantly correlated with those in the fasting and 2 hr PP glucose and insulin levels and those in the fasting and 1/2 hr insulin/glucose ratios (r from 0.47 to 0.76). Also, the intrapair differences in the dietary fat calories were correlated positively, but those in the calories derived from carbohydrates negatively, with the intrapair differences in several parameters of the glucose and insulin metabolism. These data suggest that the environmental contribution to the regulation of glucose and insulin metabolism in subjects within the normoglycemic range may be quite strong. Of the environmental factors studied, obesity and dietary fat consumption seem to have powerful regulatory roles, particularly in the response of insulin to the glucose load.

Within the Finnish Twin Cohort of like-sexed adult twin pairs, a subgroup of pairs separated at an early age has been identified. In 165 pairs, both cotwins responded to questionnaires in 1975 and 1979. An environmental dissimilarity score was formed which consists of items on whether the twins had lived after separation in the same community, attended the same school, were on the same grade at school, how often the cotwins met, how often they met common friends and relatives and whether they attended the same clubs etc, or not. To validate the zygosity diagnosis obtained by questionnaire in 1975, those pairs whose zygosity was unknown as well as those with the least contact after separation were contacted for blood sampling (11 bloodgroups). Of 15 pairs with no zygosity diagnosis, 10 responded (1 no address,2 abroad,2 refused). Six pairs were classified MZ and 4 DZ. In 12 MZ and 8 DZ pairs undergoing bloodgroup determination, the classification of only one pair changed from DZ to MZ. The following intraclass correlations for height and weight were found:

A 38-year-old woman, gravida 5, para 3, with a triplet prgnancy discordant for anencephaly, is reported. The diagnosis was made prenatally by ultrasound. Autopsy of the anencephalic member revealed small adrenal glands with absent fetal cortex, and a coincidental tetralogy of Fallot. Studies of the histocompatible lymphocyte antigens of both parents were performed and they failed to demonstrate HLA B-27. The literature on anencephaly in triplets is summarized. The association of congenital heart disease and HLA B-27 with anencephaly is discussed.

Six skinfold measurements, and percent body fat and fat-free weight derived from the underwater weighing technique were obtained in 43 pairs of male and 44 pairs of female monozygotic (MZ) twins. A fat tissue biopsy was performed in the suprailiac region in 20 male and 16 female pairs in order to determine mean adipocyte diameter and basal lipolysis as well as epinephrine maximally stimulated lipolysis (10−4 M). Twin resemblance in body fatness is clearly demonstrated by the analysis of the between MZ sibships over the within MZ shibship means of squares for all skinfold measurements, percent body fat and fat free weight (P < 0.01). Within MZ pair similarity is as high in female as in male pairs for body fatness. Moreover, members of the same twin pair resemble one another significantly for fat cell size and fat cell lipolytic activities, particularly when epinephrine stimulated. In female MZ pairs, additional studies with control over the menstrual cycle are needed to clarify the case of isolated fat cell basal lipolysis.

During a 10-year period (1971-1980) 16 sets of conjoined twins were delivered in the author's hospital. The incidence of those twins was 1 in 4242 deliveries, 1 in 69 multiple births, and 1 in 139 congenitally malformed babies. All diagnoses were made during labour or at operation and all babies were lost. There were no maternal deaths.

This study is based on data from 165 adult twin pairs separated at 10 years or less. Information on personality factors: extraversion (E) and neuroticism (N) (EPI scale short from), life satisfaction (LS) (Allardt) and stress of daily activities (SDA) was obtained as part of the questionnaire study carried out in the entire Finnish Twin Cohort in 1975. Later in 1979 a questionnaire sent to the twins reared apart yielded a scale (range 7-30 points) measuring the environmental dissimilarities after separation (reliability 0.83). The effect of separation on personality factors by analysis of variance of individual data was studied. Sex, zygosity and age-at-separation were included in the models. The overall expalanatory rates were low (2.1-4.4%). The definitive study group was formed by selecting those pairs with a dissimilarity score greater than 15. The following intraclass correlations were obtained:

A case is reported of a 14-year old male MZ twin pair, with only one partner affected by situs viscerum inversus, whereby the condition is termed situs viscerum specularis. The high degree of mirror imaging is seen as an abnormal variation of the biological time of the cleavage giving rise to MZ twinning. Electrocardiographic findings are presented and the biological implications of the condition are discussed.

Three questionnaires measuring altruistic tendencies were completed by 573 adult twin pairs from the University of London Institute of Psychiatry Volunteer Twin Register. The questionnaires consisted of a 20-item Self-Report Altruism Scale, a 33-item Empathy Scale, and a 16-item Nurturance Scale, all of which had previously been shown to have construct validity. For the three scales, the intra-class correlations for the 296 MZ pairs were 0.53, 0.54, and 0.49, and for the 179 same-sex DZ pairs were 0.25,020, and 0.14, giving rough estimates of broad heritability of 56%, 68%, and 72%, respectively. Maximum-likelihood model-fitting revealed about 50% of the variance on each scale to be associated with genetic effects, virtually 0% to be due to the twins' common environment, and the remaining 50% to be due to each twins' specific environment and/or error associated with the test.

In an attempt to uncover the causes of variation in birth weight for 13,970 offspring of MZ and DZ twins, several models were tested. Mean squares from nested analysis of variance were analysed with respect to fetal and maternal effects on variation in birth weight. The major part of the total variation in birth weight was found to be due to effects of genes. The contribution of fetal genes was larger than the contribution of maternal genes. About 11% of the variation could be attributed to effects of interactions between fetal and maternal genes. However, in this data set, the interaction variance could not be distinguished from variance due to fetal dominance or to effects of common environment of sibs.

Establishment of the Kaiser- Permanente Twin Registry permitted the study of disease heritability in twins based on review of the twins' medical records. The records of 930 pairs of twins were reviewed. Based on previous questionnaires, 342 pairs were MZ, 345 were DZ and 243 were of unknown zygosity. Because of the age distribution of these twins and the time period in which they received care, conditions of youth, such as acne vulgaris were most reliably studied Heritability of acne was assessed in three ways; all indicated a substantial genetic influence. Certain problems with twin studies using medical records became apparent: 1) Zygosity information is often lacking; 2) Differing times and durations of observation of the two twins in each pair must be accounted for; 3) Categorization by diagnosis is difficult and strict criteria for diagnosis may be impractical; 4) Patients' behavior that affects assessment of disease concordance must be considered; 5) The order in which records are reviewed may influence apparent concordance.

A simple path model applicable to twins and their parents and involving both cultural and genetic transmission in the presence of phenotypic assortative mating was extended to cover the bivariate case. The model allows for cross assortative mating as well as cross cultural transmission. It was applied to two correlated measures derived from a fear survey questionnaire given to 1000 subjects. In allowing for the impact of more than one variable, the model allows for a much more realistic picture of cultural transmission than provided by the univariate model. The logic of the model and an application are outlined. (The authors are indebted to Professor R.J. Rose for providing the illustrative data.)

During 1967-79 the population-based Medical Birth Registry of Norway registered 7,660 twin pairs (1% of births) born to 7,596 mothers, who gave birth to 6,608 additional infants (twin siblings). The total rate of malformations among twins (278.1/10,000) was not significantly different than among singletons (302.1/10,000), nor among twin siblings (314.8/10,000). By specific type of defect, twins had significantly higher rates than singletons of central nervous system (CNS) defects (Rate Ratio = 1.8) and cardiovascular defects (RR = 1.5). The twins also had a significantly low rate of congenital hip dislocation (RR = 0.4), which may explain the relatively low incidence of malformations in twins. Like-sex (LS) twins had a slightly higher rate of malformations than unlike-sex (US) twins (RR = 1.1), as well as a higher rate of CNS defects (RR = 3.0). The siblings also had a significantly increased rate of CNS defects compared to singletons (RR = 1.9), but not of cardiovascular defects (RR = 0.9). The results indicate that twins have elevated rates of at least some congenital malformations. The observations about CNS defects suggest common factors that can lead to either like-sex twinning, CNS defects, or both. The increased frequency of cardiovascular defects in twins appears to be associated with the biologic conditions of twinning.