Growth stanza in fish life history using otoliths shape: the protandric Centropomus case (Carangaria: Centropomidae)

Morphoanatomical or physiological changes coupled with changes in body size are known as allometric relationships. The objective of this study was to identify the points of growth changes in Centropomus based on otolith morphometry and morphogeometry. For this purpose, 455 individuals of C. undecimalis and 176 of C. parallelus were collected from artisanal fishermen of the coast of the state of Alagoas, Brazil. The sagittal otoliths were measured for length, height, perimeter, area and weighed. The potential and polyphasic models were fitted between total fish length and otolith length. The morphotypes otoliths wen describe by form Fourier descriptors and shape indices. The polyphasic model detected three growth phases. The first stanza for C. undecimalis was at 46.8 cm and the second at 75.9 cm. For C. parallelus, it was at 18.8 cm and at 41.2 cm. Each stanza has a specific otoliths morphotype in both species. The otoliths of C. undecimalis and C. parallelus exhibited ontogenetic allometric changes in their growth pattern with two stanzas changing points. The stanzas corresponded to specific lengths reached by individuals over their life cycles, such as their size at maturity and length at sexual reversion.(AU)

Mudanças morfoanatômicas ou fisiológicas em conjunto com mudanças no tamanho do corpo, são conhecidas como relações alométricas. O objetivo do estudo foi identificar os pontos de mudanças de crescimento de Centropomus com base na morfometria e morfogeometria dos otólitos. Foram coletados 455 indivíduos de C. undecimalis e 176 de C. parallelus, adquiridos com pescadores artesanais do estado de Alagoas, Brasil. Os otólitos sagitta foram medidos quanto ao comprimento, altura, perímetro, área e pesados. Os modelos potencial e polifásico foram ajustados entre o comprimento do peixe e o comprimento do otólito. Os morfotipos de otólitos são descritos por descritores de Fourier e índices de forma. O modelo polifásico detectou três fases de crescimento. A primeira stanza para C. undecimalis foi em 46,8 cm e a segunda em 75,9 cm. Já C. parallelus, a primeira foi em 18,8 cm e segunda em 41,2 cm. Cada stanza possui um morfotipo específico de otólitos em ambas as espécies. Os otólitos de C. undecimalis e C. parallelus exibiram mudanças alométricas ontogenéticas em seu padrão de crescimento com dois pontos de mudança de stanzas. As stanzas corresponderam a comprimentos específicos alcançados por indivíduos ao longo de seus ciclos de vida, como seu tamanho na maturidade e comprimento na reversão sexual.(AU)

Abordaje del recién nacido con alteraciones del desarrollo sexual / Newborn approach with disorders of sexual development

Resumen Introducción: Las alteraciones del desarrollo sexual en el recién nacido no es una condición infrecuente durante la práctica médica pero sí resulta ser un reto tanto en el abordaje diagnostico como en el terapéutico. Se definen como el conjunto de condiciones en donde el desarrollo del sexo cromosómico, gonadal o anatómico es atípico. Objetivos: Realizar un abordaje integral de las alteraciones del desarrollo sexual y reconocer la importancia de los equipos transdisciplinarios para el manejo de esta patología. Metodología: Se realizó una búsqueda de la literatura con las palabras clave Disorders of sex development, Ovotesticular disorders of sex development, True Hermaphroditism, Gonadal dysgenesis, Adrenal hyperplasia, congenital en cinco bases de datos bibliográficas, se limitó la búsqueda para artículos en idioma español o inglés de los últimos 10 años. Resultados: Se obtuvieron110 artículos de los cuales 36 fueron incluidos en esta revisión, los artículos revisados eran artículos originales, presentación de casos, consensos y artículos de revisión. Conclusiones: La sensibilización al personal de salud sobre esta condición es fundamental para realizar un diagnóstico y tratamiento oportuno, con el objetivo de evitar complicaciones en la salud del recién nacido. La asignación del sexo es uno de los problemas más relevantes para el manejo de esta patología; esta decisión deberá ser tomada por el equipo transdisciplinario de especialistas con experiencia en el tema en donde se realice una evaluación detallada e individual de cada caso.

Abstract Introduction: Disorder of sexual development in newborn is not an infrequent condition during medical practice, but it does prove to be a challenge both in diagnostic and in therapeutic approaches. It is defined as the set of conditions in which the development of chromosomal, gonadal or anatomical sex is atypical. Objectives: To carry out a comprehensive approach to sexual development alterations and to recognize the importance of transdisciplinary teams for the management of this pathology. Methodology: A search of review literature was made with the key words Disorders of sex development, Ovotesticular disorders of sex development, true hermaphroditism, gonadal dysgenesis, and congenital adrenal hyperplasia in five biomedical databases. The search has been limited to Spanish or English language articles of the last 10 years. Results: 110 articles were reviewed, of which 36 were included, they were original articles, case presentations, consensus and review articles. Conclusions: In order to avoid complications in newborn, health personnel should be sensitized, regarding this condition is essential to timely diagnosis and treatment. Assignment of sex is one of the most relevant problems for the management of this condition; this decision must be made by a transdisciplinary team of specialists with experience in the subject where a detailed and individual evaluation of each case is carried out.

Histological study of annual cycle of gonad and germ cell development of Whitmania pigra / 中国中药杂志

The reproductive system and gonad development and germ cell occurrence of Whitmania pigra have been studied by using tissue section electron microscope techniques. W. pigra has completely independent male and female reproduction system, which lasts 11 months. The development of spermary started before the development of ovary. When egg cell is only a primordial germ cell, sperm has an initially complete form. Meanwhile, sperm cells and egg cells orderly development and synchronously mature. According to the development of sperm cells and egg cells, the development of cycle of the spermary could be divided into 6 stages: proliferating stage (1-3 months of age), growing stage (4-5 months of age), resting stage (6-8 months of age), maturing stage (9 months of age), spawning stage (10 months of age) and degradation stage (11 months of age). The development of cycle of the ovary could be divided into 6 stages: forming stage (1-2 months of age), proliferating stage (3-4 months of age), growing stage (5-8 months of age), maturing stage (9 months of age), spawning stage (10 months of age) and resting stage (11 months of age). W. pigra is a synchronous hermaphrodite animal, the development of cycle of the spermary and ovary each has six stages, sperm cells and egg cells orderly development and synchronously mature.

Reproducción de los róbalos Centropomus undecimalis y C. Ensiferus (Perciformes: Centropomidae) en una laguna costera tropical / Reproduction of Centropomus undecimalis and C. ensiferus (Perciformes: Centropomidae) in a tropical coastal lagoon

ResumenLos róbalos (C. undecimalis y C. ensiferus) son recursos pesqueros de importancia en toda su área de distribución. En Venezuela son capturados por pesquerías artesanales a lo largo de toda la costa, sin embargo, los estudios sobre su biología que permitan orientar regulaciones de su pesca son escasos. Para analizar aspectos de la reproducción de ambas especies se analizaron 1 325 individuos de C. undecimalis y 2 025 de C. ensiferus, provenientes de la pesca artesanal en la Laguna de Tacarigua, en el norte de Venezuela, desde julio 2009 a septiembre 2010. Se midió la longitud total, peso total, sexo y madurez sexual de cada individuo. La proporción sexual varió a lo largo del año, se observó una diferencia significativa en favor de los machos para C. undecimalis (1:1.5) y de las hembras para C. ensiferus (1:3.3). Se evidenciaron diferencias en la proporción sexual de la talla para ambas especies: los machos dominan las tallas inferiores, mientras que las hembras dominan las superiores. Lo cual señala un patrón típico de hermafroditismo secuencial (protándrico) en ambas. Se estimaron las tallas de madurez sexual (Lm50) para C. undecimalis (♀= 73.6 y ♂= 59.3 cm) y C. ensiferus (♀= 26 y ♂= 21.5 cm). C. ensiferus se reproduce durante todo el año con dos periodos de mayor intensidad (agosto a septiembre y febrero a abril), mientras para C. undecimalis fueron escasos los individuos maduros, mostrando febrero el pico de reproducción más importante. Se encontró diferencia en el crecimiento entre machos y hembras de C. undecimalis: alométrico positivo para hembras (P= 0.0022*L3.353) y negativo para machos (P= 0.0108*L2.945), mientras no se encontraron diferencias para C. ensiferus, que presentó alometría positiva (P= 0.0049*L3.235) para ambos sexos. La falta de regulación y controles de pesca, la evidencia de importantes volúmenes de individuos inmaduros en las capturas, así como el carácter particular de la biología reproductiva de estas especies, sugiere la necesidad de establecer regulaciones para garantizar su aprovechamiento responsable, como un periodo de veda durante el primer trimestre de año y tallas mínimas de captura para ambas especies.

Abstract:Snooks C. undecimalis and C. ensiferus are important fishery resources in their distribution area. In Venezuela they are caught by artisanal fisheries along the entire coast. However, studies on their biology that would help establish fishing regulations are scarce. To study reproduction aspects of these species, we analyzed 1 325 individuals of C. undecimalis and 2 025 of C. ensiferus caught by artisanal fishing in the Laguna de Tacarigua in Northern Venezuela, from July 2009 to September 2010. Total length, total weight, sex and stage of gonadal development were recorded. The sex ratio varied throughout the year: there was a significant difference in favor of C. undecimalis males (1.5:1), and C. ensiferus females (1:3.3). Differences were also evident in the sexual proportion at each size group. For both species, males dominated in the lower size ranges while females dominated in the larger size ranges. These results suggested sequential hermaphroditism (protrandry) in both species. Size at sexual maturity (Lm50) for C. undecimalis was ♀= 73.6 and ♂= 59.3 cm, and ♀= 26 and ♂= 21.5 cm for C. ensiferus. C. ensiferus reproduced throughout the year with two periods of higher intensity (August to September and February to April). Although we found very few mature individuals for C. undecimalis, February showed an important reproduction peak. Growth differences were found between males and females of C. undecimalis: positive allometry for females (P= 0.0022*L3.353) and negative allometry for males (P= 0.0108*L2.945). Both males and females of C. ensiferus showed a positive allometric relationship (P= 0.0049*L3.235). Lack of fishing regulations and controls, evidenced in this study by significant volumes of immature individuals in the catches, and the particular reproductive biology of these species, strongly indicates the need to establish regulations to ensure their responsible use. We recommend establishing a closed season during the first quarter of the year and minimum catch sizes for both species. Rev. Biol. Trop. 65 (1): 181-194. Epub 2017 March 01.

Rediscovering hermaphroditism in Grammatidae with the description of the testicular gland in Brazilian Basslet Gramma brasiliensis / Redescobrindo o hermafroditismo em Grammatidae com a descrição da glândula testicular de Gramma brasiliensis

Abstract Many aspects of sex change in reef fishes have been studied, including behavior and social organization. However, gonad histology remains the most robust way to identify sexual patterns in fishes. Some uncommon tissues remain poorly described, such as the accessory gonadal structures found in species from the Gobiidae family, which are rare in other bony fishes. This is the first report of the testicular gland in Gramma brasiliensis and for the Grammatidae family. Between April 2011 and February 2012 eighty specimens were collected during four dive campaigns on the Taipus de Fora reef (13°56’20”S 38°55’32”W), Bahia, Northeast Brazil, and their sex was determined. Thirteen per cent of the active-females and 90% of the active-males had testicular gland tissue in their ovotestis. This discovery led to additional research into the characteristics of the gland tissue and its relationship with gonadal maturation. Three patterns of testicular gland development were found in Brazilian basslet ovotestis. Both ova and sperm-producing gonad contained testicular gland tissue, and the appearance of this tissue seems to be the first modification of ovotestis tissue marking the beginning of the protogynous sex-change process in G. brasiliensis.

Resumo Diversos aspectos da troca de sexo em peixes recifais vem sendo estudados, incluindo comportamentos e organização social. Entretanto, a histologia das gônadas continua sendo a maneira mais robusta para se identificar padrões sexuais em peixes. Alguns tecidos incomuns, tais como as estruturas anexas a gônada encontradas em espécies da família Gobiidae e raras em outras espécies são pouco estudados. Este trabalho é a primeira descrição da glândula testicular em Gramma brasiliensis e para a família Grammatidae. Entre abril de 2011 e fevereiro de 2012, oitenta espécimes foram coletados durante quatro amostragens no recife de Taipus de Fora (13°56’20”S 38°55’32”W), Bahia, Brasil, e tiveram seus sexos determinados. Treze por cento das fêmeas ativas e noventa por cento dos machos ativos apresentaram tecido da glândula testicular em suas gônadas. Esta descoberta levou ao estudo da características dessa estrutura e sua relação com a maturação gonadal. Foram identificados três padrões de desenvolvimento da glândula testicular nas gônadas do Gramma brasiliensis. Tanto as gônadas produtoras de espermatozoides quanto as de oócitos apresentaram tecido da glândula testicular, e o surgimento desse tecido parece ser a primeira modificação gonadal do início da troca de sexo protogínica em G. brasiliensis.

First record of a male of Kryptolebias hermaphroditus Costa, 2011 (Cyprinodontiformes: Cynolebiidae)

During an ichthyological survey in September 2015 at the Ceará-Mirim River estuary, Rio Grande do Norte State, northeastern Brazil, we collected a male of Kryptolebias hermaphroditus , a cynolebiid species that had been previously described as containing exclusively self-fertilizing hermaphrodites. This is the first record of a male in this species, over 140 years after the discovery of the mangrove rivulid species from Brazil. Our discovery reinforces the need for more studies in K. hermaphroditus , as well as the potential of this species as a model for evolutionary studies due to its unique mating system.(AU)

Durante uma amostragem ictiológica em setembro de 2015 no estuário do rio Ceará-Mirim, Estado do Rio Grande do Norte, Nordeste do Brasil, nós coletamos um macho de Kryptolebias hermaphroditus , uma espécie de rivulídeo que foi descrita como contendo apenas hermafroditas auto-fertilizantes. Este é o primeiro registro de um macho dessa espécie, mais de 140 anos depois da descoberta das espécies de rivulídeos de manguezais do Brasil. Nossa descoberta reforça a necessidade de mais estudos em K . hermaphroditus , assim como, o potencial desta espécie como um modelo para estudos evolutivos devido ao seu sistema reprodutivo único.(AU)

Perioperative nursing of 6 patients with true hermaphroditism / 现代临床护理

Objective To explore the perioperative nursing points of 6 patients with true hermaphroditism. Method Six patients with true hermaphroditism from September 2009 to February 2014 were treated with surgeries , with perioperative nursing performed. Result All the operations were successful without serious complications and the wounds were on primary healing. Conclusions Perioperative nursing interventions over the patients with true hermaphroditism can alleviate role conflicts and help them overcome the psychological obstacles. Postoperative nursing including careful care to the perineum incisions and artificial vaginas, and health instruction can ensures postoperative rehabilitation.

Origin and occurrence of sexual and mating systems in Crustacea: A progression towards communal living and eusociality.

Crustaceans are known for their unrivalled diversity of sexual systems, as well as peculiar mating associations to achieve maximum mating success and fertilization accomplishment. Although sexes are separate in most species, various types of hermaphroditism characterize these predominantly aquatic arthropods. A low operational sex ratio between female and male, together with temporally limited receptivity of females towards males, imposes restrictions on the structuring of mating systems in crustaceans. The basic mating systems consist of monogamy, polygamy, mate guarding and pure searching. Understandably, ecological influences may also play a determinative role in the evolution of such sexual and mating systems in crustaceans. An important outcome of the crustacean sexual biology is the development of complex social structures in many aquatic species, in much the same way insects have established them in terrestrial conditions. In addition, groups like isopods and certain families of brachyuran crabs have shown terrestrial adaptation, exhibiting peculiar reproductive modes, sometimes reminiscent of their terrestrial counterparts, insects. Many caridean shrimps, living in symbiotic relationship with other marine invertebrates in the coral reef habitats, have reached pinnacle of complexity in sexuality and peculiar mating behaviours, resulting in communal living and establishing advanced social systems, such as eusociality.

Reproductive cycle and embryonic development of the gastropod Melampus coffeus (Linnaeus, 1758) (Ellobiidae) in the Brazilian Northeast / Ciclo reprodutivo e desenvolvimento embrionário do gastrópode Melampus coffeus (Linnaeus, 1758) (Ellobiidae) no Nordeste do Brasil

Melampus coffeus belongs to a primitive group of pulmonate mollusks found mainly in the upper levels of the marine intertidal zone. They are common in the neotropical mangroves. Little is known about the biology of this species, particularly about its reproduction. The aim of this study was to 1) characterize the morphology and histology of M. coffeus' gonad; 2) describe the main gametogenesis events and link them to a range of maturity stages; 3) chronologically evaluate the frequency of the different maturity stages and their relation to environmental factors such as water, air and sediment temperatures, relative humidity, salinity and rainfall; and 4) characterize M. coffeus' spawning, eggs and newly hatched veliger larvae. Samples were collected monthly between February, 2007 and January, 2009 from the mangroves of Praia de Arpoeiras, Acaraú County, State of Ceará, northeastern Brazil. The characterization of the gonad development stages was carried out using routine histological techniques. The results of this study show that Melampus coffeus is a simultaneous hermaphrodite. The follicles have masculine and feminine elements, interleaved within the gonad. M. coffeus presents a well-defined synchronous reproductive cycle, showing successive maturation, release and resting periods. The average diameter of the oocytes was negatively correlated with salinity and positively correlated with rainfall. The results show that no reproductive activity occurs during periods of drought. After the dry season, the increasing rainfall levels and reduced salinity lead to the appearance of very dense populations, predominantly composed of small individuals.

Melampus coffeus encontra-se em um grupo primitivo de moluscos pulmonados, primordialmente marinhos, habitantes dos níveis superiores da zona entremarés, comum em manguezais do Oceano Atlântico. Pouco se sabe sobre a biologia da espécie, em especial, sobre a sua reprodução. Os objetivos deste trabalho foram: 1) caracterizar morfo-histologicamente a gônada de M. coffeus; 2) descrever os principais eventos da gametogênese e associá-los a uma escala de estágios de maturidade; 3) avaliar temporalmente a frequência dos estágios de maturidade e sua possível relação com os fatores ambientais, como a temperatura da água, do ar e do sedimento, a umidade relativa, a salinidade e a pluviosidade, e 4) caracterizar a postura, os ovos e a véliger recém-eclodida de M. coffeus. Foram realizadas coletas mensais de fevereiro de 2007 a janeiro de 2009, no manguezal da Praia de Arpoeiras, município de Acaraú-Ceará, na Região Nordeste do Brasil. A caracterização das fases de desenvolvimento da gônada foi realizada utilizando-se técnicas histológicas de rotina. Os resultados deste estudo mostram que Melampus coffeus é um hermafrodita simultâneo. Os folículos apresentam elementos masculinos e femininos, distribuindo-se na gônada intercalados radialmente. M. coffeus apresenta um ciclo reprodutivo sincrônico bem definido, evidenciando-se períodos sucessivos de amadurecimento, de liberação e de repouso. O diâmetro médio dos oócitos apresentou correlação negativa com a salinidade e positiva com a pluviosidade. Os resultados indicam que, nos períodos de estiagem, não há atividade reprodutiva. Após essa estação, quando os valores de pluviosidade aumentam e a salinidade diminui, as populações são bastante densas e predominam indivíduos pequenos.

Hermafroditismo verdadeiro: relato de caso / True hermaphroditism: case report

Objetivo: relatar o acompanhamento multidisciplinar de um caso de hermafroditismo verdadeiro HV,diagnosticado na Fundação Santa Casa de Misericórdia do Pará. Relato de caso: paciente nascido em2000, apresentando ao exame físico falus de 1,5cm de comprimento, bolsa escrotal bífida,transposição penioescrotal, sinus urogenital, gônada esquerda canalicular distal com 1cm de diâmetro,móvel e de consistência fibroelástica, e não palpável à direita, sem demais alterações. A investigaçãodiagnóstica seguiu com realização de cariótipo [46 XY ? 90%; 45 Xr (?Y) ? 6%; 45 X ? 4%]; examesendocrinológicos; ultrassonografia e genitografia. Foi submetido à laparotomia exploradora, comidentificação de útero rudimentar, tubas uterinas bilateralmente, gônada direita na cavidade de aspectoarredondado e gônada esquerda penetrando no anel inguinal profundo. Biópsia de congelação teveresultado inconclusivo, mas após revisão diagnosticou ovotéstis bilateralmente e presença de tecidoepididimário e tuba ovariana. Assim, o diagnóstico de HV foi estabelecido. Foi realizada novalaparotomia exploradora, histerectomia total, salpingectomia com gonadectomia direita, gonadectomiaesquerda por via escrotal e vaginectomia. Em 2009, foi realizado o primeiro tempo da correção dehispospádia perineal. Considerações finais: diferente do que acontece na maioria dos casos, o casorelatado tem cariótipo em mosaico, acompanhado de ambigüidade genital, o que possibilitouinvestigação precoce, visto que o tratamento tardio na maioria das vezes se justifica pela falta dealteração na genitália externa. O acompanhamento multidisciplinar foi determinante para a conduçãodo caso.

Objective: to report the multidisciplinary follow-up of a diagnosed case of true hermaphroditism inthe Santa Casa de Misericórdia do Pará. Final Considerations: unlike what happens in most cases,the reported case is a mosaic kariotype, with ambiguous genitalia, which allowed an earlyinvestigation, since the late treatment is most often justified by the lack of change in the externalgenitalia. The follow-up was crucial to the conduct of the case.

Value of ultrasonography in the diagnosis of hermaphroditism / 中华超声影像学杂志

Objective To evaluate the clinical value of ultrasonography in the diagnosis of hermaphroditism.Methods Ultrasonographic appearances of 45 cases with hermaphroditism were reviewed retrospectively,and the results were compared with clinical data.Results All cases were confirmed pathologically.5 cases showed true hermaphroditism (11.1％),14 cases showed male pseudohermaphroditism (31.1 ％),24 cases showed female pseudohermaphroditism (53.3 ％),2 cases showed gonadal dysgenesis(4.4％).Compared with pathological results in the ultrasound examination,4 cases showed true hermaphroditism,the coincidence rate was 80％.11 cases showed male pseudohermaphroditism,the coincidence rate was 78.6％.20 cases showed female pseudohermaphroditism,the coincidence rate was 83.3％.1 cases showed gonadal dysgenesis,the coincidence rate was 50.0％.Conclusions Ultrasonography can not only evaluate internal reproductive organs in the patients,but also estimate the site,size,morphology and structure,which provides important imaging evidence for the clinical diagnosis and treatment.

Hermaphroditism in marine mussel Perumytilus purpuratus (Lamarck, 1819), (Mollusca: Mytilidae) / Hermafroditismo en el chorito Perumytilus purpuratus (Lamarck, 1819), (Mollusca: Mytilidae)

Marine bivalves are essentially gonochoric species. However, some occasional hermaphrodites specimens can be found. A histological description of two (among 179) hermaphrodites of the marine mussel Perumytilus purpuratus (Lamarck, 1819) that were collected in San Jorge Bay (24S) is given. The low proportion of hermaphrodites suggests that P. purpuratus hermaphroditism could be an accidental phenomenon; nevertheless other causes are also discussed in the present study.

Los bivalvos marinos son principalmente especies gonocoricas. Sin embargo, ocasionales especímenes hermafroditas pueden encontrarse. Una descripción histológica de dos (de 179) especímenes hermafroditas del chorito Perumytilus purpuratus (Lamarck, 1819) es registrada, los que fueron colectados en la bahía de San Jorge (24S). La baja proporción de hermafroditas de Perumytilus purpuratus sugiere que podría ser un fenómeno accidental, aun así otras posibles causas son discutidas en el presente estudio.

Hermaphroditism among dioecious Tagelus plebeius (Lightfoot, 1786) (Mollusca, Psammobiidae) and Iphigenia brasiliana (Lamarck, 1818) (Mollusca, Donacidae) on the Cachoeira River Estuary, Ilhéus, Bahia, Brazil / Hermafroditismo nos moluscos dióicos Tagelus plebeius (Lightfoot, 1786) (Mollusca, Psammobiidae) e Iphigenia brasiliana (Lamarck, 1818) (Mollusca, Donacidae) na região estuarina do Rio Cachoeira, Ilhéus, Bahia, Brasil

The samples of Tagelus plebeius and Iphigenia brasiliana were manually collected on the Cachoeira River estuary region (Ilhéus, BA, Brazil) between August 2005 and August 2006, with a periodicity of 15 days, with 20 animals collected/sampled, performing 500 samples from each species. The animals were measured, eviscerated and kept in solution of Davidson and after 24-30 hours, they were transferred to ethanol 70 percent. The material was processed for routine histology, with paraffin embedding, obtaining 7 μm thick slices, stained with Harris hematoxilin and Eosin (HE). By light microscopy analysis, 2 cases of hermaphroditism (0.4 percent) in T. plebeius samples and one case (0.2 percent) in I. brasiliana were registered with predominance of female over male follicles.

Os exemplares de Tagelus plebeius e Iphigenia brasiliana foram manualmente coletados na região estuarina do Rio Cachoeira (Ilhéus, Bahia), entre agosto de 2005 e agosto de 2006, com coleta quinzenal de 20 animais, totalizando 500 exemplares/espécie. Os animais foram mensurados, eviscerados e fixados em solução de Davidson por 24-30 horas e depois transferidos para etanol a 70 por cento. O material foi processado por técnica rotineira de histologia, com inclusão em parafina, obtenção de cortes com 7 μm de espessura e coloração por hematoxilina de Harris e Eosina (HE). A análise em microscopia de luz evidenciou 2 casos de hermafroditismo (0,4 por cento) em T. plebeius e um caso (0,2 por cento) em I. brasiliana (0,2 por cento), com predominância de folículos femininos sobre os masculinos.

Clinical Findings and Characteristics of Gonad at Diagnosis of Ovotesticular Disorders of Sex Development / 대한소아내분비학회지

PURPOSE: Ovotesticular disorder of sex development (OTDSD) is rare condition and defined as the presence of both ovarian and testicular tissues in the same individual. We aimed to investigate clinical characteristics of patients and histologic findings of gonads at diagnosis of OTDSD and to characterize patients diagnosed with gonadal tumor. METHODS: We retrospectively reviewed the records of 20 patients histologically confirmed as OTDSD between 1980 and 2009 in Seoul National University Hospital. Age, chief complaints, karyotype, external and internal genital organs at diagnosis and gonadal histology were investigated. RESULTS: Age at histologic diagnosis of OTDSD was 5.1 years of age (0.1 - 28 yr). Chief complaints at diagnosis included wide spectrum of ambiguous genitalia including hypospadia and clitoromegaly (n = 15), inguinal mass (n = 3) and gynecomastia (n = 2). Thirteen cases (65%) showed 46,XX karyotype and 24 (61.5%) of 39 gonads histologically confirmed ovotestes. Testis was found in right (83.3%), in inguinal or scrotal area (84.2%) and ovary was in left (88.9%), in pelvis or abdomen (88.9%). Three cases (15%) were diagnosed with gonadal tumor, who all had undergone gonadectomy in the second decade due to belated identification of gonad (10 yr) despite early diagnosis, incidentally developed clitoromegaly (12.9 yr), and inguinal mass (28 yr) after surgical correction of clitoromegaly at 2.9 years of age. CONCLUSION: Patients with OTDSD had wide spectrum of ambiguous genitalia including hypospadia and clitoromegaly. This study provides the importance of early diagnosis and gonadectomy in patients with OTDSD considering increased risk for gonadal tumor in the second decade.

As novas definições e classificações dos estados intersexuais: o que o Consenso de Chicago contribui para o estado da arte? / New definitions and classifications of the intersexual states: in which the Chicago Consensus has contributed to the state of the art?

As anomalias da diferenciação sexual têm-se constituído em um formidável desafio quanto ao diagnóstico e à conduta, colocando o paciente, os familiares e os profissionais da equipe de saúde na difícil situação de definir a melhor opção quanto ao gênero de criação. Uma terminologia confusa e estigmatizante tem sido adotada e, nesse sentido, o Consenso de Chicago propõe várias modificações no sentido de minimizar os desconfortos graças a uma terminologia que nem sempre auxilia na solução de problemas. Os autores fazem uma análise crítica da classificação sugerida pelo Consenso, levantando a questão de que, na nova classificação, também não se resolvem certos problemas terminológicos e continua a se criar algum grau de estigmatização. Em primeiro lugar, a sugestão de se incluir o cariótipo no nome da doença supõe, erroneamente, que os pacientes não tenham conhecimento do que significa ser 46,XY ou 46,XX. Uma criança criada no sexo feminino com uma anomalia da diferenciação sexual (ADS) 46,XY não vai entender porque está no sexo feminino se seu cariótipo é "masculino". A substituição do termo hermafroditismo verdadeiro por ADS ovotesticular está longe de resolver o problema de estigmatização causado por "hermafroditismo". O termo ovotesticular é claramente entendido como uma fusão entre ovário e testículo e não será aceito com "naturalidade". Se, por um lado, é muito satisfatório que a questão da nomenclatura seja discutida, por outro lado devemos escolher termos alternativos que sejam realmente neutros e não tragam, em si, a conotação de um sexo que pode não condizer com o escolhido para aquele paciente em particular. Um ponto em que todos concordamos é que a substituição de intersexo por anomalia da diferenciação sexual (ADS) ou, disorder of sex development (DSD), na língua inglesa, cai muito melhor e não dá a conotação de um "sexo intermediário" como o nome antigo proporcionava.

Disorders of sex development have posed a tremendous challenge not only in the diagnosis but also in the treatment, placing the patient, the family members, and the health team in the difficult task of attributing the best sex of rearing for that specific patient. A confusing and stigmatizing nomenclature has been employed and the Chicago Consensus tried to minimize the discomfort with modifications of the current terminology. The authors perform a critical analysis of the Consensus, raising the question that the new terminology does not solve the problems and persist being stigmatizing to the patient and to the family. First of all, the inclusion of the karyotype in the name of the disease holds the false premise that the patients do not know the meaning of a 46,XY or a 46,XX karyotype. A child raised in the female sex will not understand that her disease holds a "male" karyotype in its name (46,XY DSD). The substitution of ovotesticular DSD for true hermaphroditism maintains the stigma of the name since ovotesticular is easily perceived as ovarian and testicular tissues. If, on one hand, the recognition of using terms like intersex and hermaphroditism are stigmatizing, on the other hand, we need terms that are really neutral to not create problems of sexual identification. One point in which there is consensus is that the change of the term "intersex" for "disorder of sex development" is highly desirable and eliminates the idea of an "intermediate sex".

True hermaphroditism presenting as an inguinal hernia

A 21-year-old patient with cryptorchidism was found to have a left inguinal mass on physical examination. The patient was operated with a diagnosis of bilateral cryptorchidism and left inguinal hernia. Besides bilateral inguinal undescended testicles, female genital organs like fallopian tubes, uterus and ovary were found on the exploration.

Mixed Gonadal Dysgenesis Mimicking True Hermaphroditism

A differential diagnosis between the true hermaphroditism (TH) and mixed gonadal dysgenesis (MGD) has important clinical implications for gender assignment and the decision for early gonadectomy; however, variable clinical and histological features frequently lead to the confusion of TH with MGD. A 17- month-old boy was presented with proximal hypospadias with chordee and right non-palpable testis in his scrotum. He also had right auricular anomaly including a separated tragus with skin tag. Left testis was well palpable in his left scrotum. Diagnostic right inguinal exploration showed Mullerian structures such as a gonad like an ovary and a fallopian tube with a uterus, which were removed. Repair of hypospadias and right auricular anomaly was also done. Following ultrasonography (USG) showed a normal looking testis in left scrotum. His chromosome was 45, XO/46, XY. We report a difficult case of mixed gonadal dysgenesis mimicking true hermaphroditism which combines ipsilateral congenital auricular anomaly.

Hermafroditismo Verdadero

Objetivo: El hermafroditismo verdadero (HV) es una forma poco frecuente de ambigüedad genital, caracterizado por la presencia de tejido ovárico y testicular maduro en el mismo individuo. En el presente estudio se presentan y discuten los casos de HV atendidos en el Hospital de Niños J. M. de los Ríos. Caracas- Venezuela durante los años 2000-2004. Métodos: Se describen manejo y diagnóstico: clínica, cariotipo, exámenes hormonales, ecografía, evaluaciones endoscópicas y los resultados de anatomía patológica. Resultados: En el Hospital José Manuel de los Ríos, entre los años 2000 a 2004, acudieron 73 pacientes con diagnóstico de ambigüedad genital, de los cuales 4 (5,47%) resultaron ser HV. ` Conclusiones: El HV es una condición, que aun cuando rara, es muy importante, ya que puede influir de manera decisiva sobre la psiquis del individuo y sobre su entorno. Debe considerarse una emergencia relativa y es prioritario dar solución al problema, tan pronto éste sea diagnosticado. Su manejo debe estar a cargo de un equipo multidisciplinario integrado por un ginecólogo infantil, endocrinólogo, urólogo, psiquiatra, genetista y trabajador social.

Objective: The true hermaphroditism (HV) is a not very frequent form of genital ambiguity. It is characterized by the presence of ovarian and testicular tissue in the same individual. In the present study we report the clinical cases evaluated at the Hospital de Niños J. M. de los Ríos. Caracas- Venezuela. Methods: A set of tests were performed: history and physical examination, blood tests, hormonal determinations, cariotype, renal and pelvic ultrasound, laparoscopy, exploratory laparotomy, hystero-salpingo-oophorectomy, and gonadal biopsy. Results: Between 2000-2004 in the Hospital José Manuel de los Ríos, 73 patients with ambiguos genitalia were studied. Four of them with true hermaphroditism (5,47%) Conclusions: The birth of a child with ambiguous genitalia represents a very stressing situation for the family, and afterwards has great social and psychological repercussion for the patient itself. Severe cases of genital anomalies must be solved after a good psychological evaluation and proper surgical repair.A multidisciplinary approach is required to guarantee the patient a proper sexual identity.

Clinical Review of the Etiologic Factors in Patients with Aambiguous Genitalia / 대한산부인과학회잡지

OBJECTIVE: To review and evaluate the etiologic factors in patients with ambiguous genitalia METHODS: We reviewed the medical records of the patients in whom ambiguous genitalia was identified in Asan Medical Center from Jan, 1989 to Dec, 2002. Patients with isolated cryptorchidism, isolated hypospadias, or congenital fatal anomalies involving multiple organs were excluded in our series. RESULTS: A total of 58 cases were evaluated. The most common cause was congenital adrenal hyperplasia (CAH) (18 cases, 31.0%), followed by partial androgen insensitivity syndrome (AIS) (16 cases, 27.6%), true hermaphroditism (9 cases, 15.5%), and mixed gonadal dysgenesis (5 cases, 8.6%). Morphologic abnormalities observed in patients with ambiguous genitalia were hypospadias (52.5%), clitoromegaly (47.5%), palpable gonads (45.8%), bifid scrotum (23.7%), penoscrotal transposition (22%), cryptorchidism (18.6%), vaginal wall abnormality (10.2%), and M llerian remnant (3.4%). By karyotyping, 46XX, 46XY, and Y containing mosaicism were found in 24, 22, and 9 patients, respectively. All of the 18 patients with CAH were found to have 21-hydroxylase deficiency and all cases of androgen insensitivity syndrome were partial type. CONCLUSION: These findings suggest that etiologic background might be different in patients with ambiguous genitalia in Korea.

Diagnosis and treatment of 138 hermaphroditism cases / 第三军医大学学报

Objective To improve the diagnosis and treatment of hermaphroditism.Methods The data of 138 cases of hermaphroditism who were hospitalized in our department between March 2005 and April 2008 were reviewed and and analyzed to summarize our experience in the diagnosis and treatment.Results Among the 138 cases with a age ranging from 2 to 36(mean 17 years old),42 were socially male and 96 were socially female.With the help of medical examination,,laboratory examination,ultrasonic examination,radiological examination and pathologic diagnosis,54 patients were diagnosed as female pseudohermaphroditism,66 as male pseudohermaphroditism,10 patients as true hermaphroditism,2 patients as pure gonadal dysgenesis,2 as testicle degeneration,and the left 4 patients as Klinefelter syndrome.Among the 138 patients,132 patients were received surgery operation,including 76 of them receiving laparoscopy.After operation,121 patients were maintained female sex,11 patients were maintained male sex.Female pseudohermaphroditism were all maintained female sex.Fifty-nine patients of male pseudohermaphroditism were maintained female sex.There were 4 patients being maintained male sex,and 3 patients having not received operation.Of the cases of the true hermaphroditism,8 patients were maintained female sex and 2 patients were maintained male sex.Conclusion Early accurate diagnosis is very important to the treatment of hermaphroditism.Etiologic diagnosis is useful in the course.Although it is good for the hermaphroditism to maintain female sex,the decision of the patients and the family should be considered.