Clinical Characterization of Patients with Ovarian Mass Combined with Dysplasia of Secondary Sexual Characteristics / 中国医学科学院学报

Objective To investigate the clinical characteristics of preadolescent and adolescent female patients with ovarian mass combined with dysplasia of secondary sexual characteristics. Methods This study retrospectively analyzed 18 cases of ovarian mass combined with dysplasia of secondary sexual characteristics aged 0-19 years admitted to Peking Union Medical College Hospital from January 2012 to November 2019.By analyzing the clinical manifestations,surgical methods,postoperative pathology,therapies and prognosis of the cases,we summarized the diagnosis and treatment ideas. Results Among the 18 cases,7(7/18,38.9%)developed secondary sex signs before puberty,including 5 cases showing precocity(including 2 cases of juvenile granulosa cell tumor,1 case of gonadoblastoma,1 case of ovarian follicular cyst,and 1 case of 46,XY simple gonadal dysplasia combined with dysgerminoma)and 2 cases presenting masculine manifestations(1 case of steroid cell tumor and 1 case of sclerosing stromal tumor).The rest 11(11/18,61.1%)cases showed abnormal development of secondary sexual characteristics during puberty,including 8 cases with masculine manifestations or abnormal menstruation after menarche(7 cases with sex cord stromal cell tumor and 1 case with cystic granulosa cell tumor),2 cases with primary amenorrhea(1 case with androgen insensitivity syndrome combined with testicular sertoli cell tumor and 1 case with endometriosis cyst combined with reproductive tract malformation),and 1 case diagnosed as 46,XX gonadal dysplasia with serous cystadenoma and no secondary sexual development during puberty. Conclusions Sex hormone levels should be actively tested in the case of prepubertal secondary sexual characteristics appearing early,pubertal secondary sexual characteristics being abnormal(underdevelopment),and/or menstrual abnormalities.Imaging examination should be performed to exclude ovarian organic lesions,and chromosome karyotype analysis should be performed if necessary.The diagnosis of ovarian mass in preadolescent and adolescent females with related symptoms should first be alerted to cord stromal cell tumor.It is recommended to rule out the possibility of combined reproductive tract malformation in the adolescent patients with primary amenorrhea.Chromosome examination should be conducted to rule out the possibility of gonadal dysplasia in the adolescent patients with primary amenorrhea and/or no development of secondary sexual characteristics.

Sexualidad y características biológicas, psicoafectivas y sociales en mujeres climatéricas / Sexuality and biological, psycho-affective and social characteristics in climacterics women

Introducción: Se desconocen las características sexuales, biológicas y psicosociales de mujeres con menopausia fisiológica, en la consulta de climaterio y menopausia. Esta información resulta importante para realizar acciones de promoción de salud. Objetivo: Determinar las características sexuales, biológicas y psicosociales más frecuentes en mujeres climatéricas. Métodos: Se realizó un estudio descriptivo, de corte transversal en 300 mujeres climatéricas, con menopausia fisiológica confirmada. Se recogió la edad (agrupada en 40-44, 45-49 y más de 49 años), el tiempo de menopausia (agrupada en menos de 3 años, 3-5 años, 6-10 años y más de 10 años), por cientopresencia de afecciones genitourinarias, síntomas físicos, psicosociales y sexuales. Resultados: Predominaron mujeres mayores de 49 años (56 por ciento) con 33,4 por ciento de 3 a 5 años de menopausia, 6,7 por ciento de atrofia genitourinaria, síntomas de sofocos 75 por ciento, dolores óseos, 70 por ciento, depresión-ansiedad y sequedad vaginal, 50 por ciento; 45 por ciento de insatisfacción sexual y dificultad en la toma de decisiones, 40 por ciento con dificultades en la comunicación con la pareja y desinterés, 38,6 por ciento tuvo disminución del deseo sexual, mientras que el 16 por ciento incrementó su apetencia sexual. Conclusiones: Las mujeres climatéricas estudiadas fueron mayores de 49 años, con menopausia entre 3 y 5 años, con bajo porcentaje de atrofia genitourinaria, con sofocos, dolores óseos, sequedad vaginal, depresión, ansiedad, dificultad en la comunicación de pareja y disminución del deseo sexual(AU)

Introduction: The sexual, biological and psychosocial characteristics of women with physiological menopause in the climacteric and menopause consultation are not known. This information is important to carry out health promotion actions. Objective: To determine the most frequent sexual, biological and psychosocial characteristics in climacteric women. Methods: A descriptive, cross-sectional study was carried out in 300 climacteric women with confirmed physiological menopause. Age (grouped in 40-44, 45-49 and more than 49 years), time of menopause (grouped in less than 3 years, 3-5 years, 6-10 years and more than 10 years), presence of genitourinary affections, physical, psychosocial and sexual symptoms. Results: Women older than 49 years (56 percent o) predominated with 33.4 percent of 3 to 5 years of menopause, 6.7 percent of genitourinary atrophy, symptoms of hot flashes 75 percent o, bone pain, 70 percent o, depression-anxiety and dryness vaginal, 50 percent o; 45 percent o of sexual dissatisfaction and difficulty in making decisions, 40 percent o with difficulties in communication with the partner and disinterest, 38.6% had a decrease in sexual desire, while 16 percent o increased their sexual desire. Conclusions: The climacteric women studied were older than 49 years, with menopause between 3 and 5 years, with a low percentage of genitourinary atrophy, with hot flashes, bone pain, vaginal dryness, depression, anxiety, difficulty in partner communication and decreased desire sexual(AU)

Cambios en los caracteres sexuales secundarios del paciente con disforia de género a consecuencia del tratamiento endocrino en Cuba / Changes in the secondary sexual characteristics of the patient with gender dysphoria as a result of endocrine therapy in Cuba

RESUMEN Introducción: La transexualidad es una incongruencia entre el sexo con el que se nace y el sexo al que se siente pertenecer, por tanto, estas personas desean cambios en su apariencia física que se logran mediante el tratamiento hormonal. Objetivo: Describir los cambios en los caracteres sexuales secundarios en pacientes con disforia de género en Cuba como consecuencia del tratamiento endocrino. Métodos: Se realizó un estudio de revisión de las historias clínicas en 76 pacientes atendidas por disforia de género en los últimos 15 años. Se extrajo la información relacionada con datos sociodemográficos y algunos cambios físicos, como resultado del traamiento hormonal. Para el análisis de los datos se obtuvieron distribuciones de frecuencia de las variables cualitativas, media y desviación estándar de las cuantitativas. Resultados: La mayoría de los pacientes corresponde a transexuales de hombre a mujer (THM). Al año, la mayoría de las personas ya tenían un estadio III o IV de desarrollo mamario (45,3 por ciento de estos tenían estadio III y el 32,3 por ciento estadio IV). Al año de iniciada la atención de los 58 pacientes, 41,4 por ciento tenían un patrón de vello triangular típico del sexo femenino con el que se identifican y a los 2 años ascendió al 80,5 por ciento. Al año se evaluaron 50 por ciento de todos los casos y en ese momento solo 5,1 por ciento mantenían un vello facial intenso y más de la mitad (56,8 por ciento), ya no tenían. Al inicio, la media del volumen testicular fue de 17,4 ml, a los 3 meses fue de 15,7 ml, a los 6 meses 14,3 ml y 9,7 ml al año. Conclusiones: Los pacientes con disforia de género en la mayoría de los casos logran cambios en los caracteres sexuales secundarios acordes al sexo con que se identifican(AU)

ABSTRACT Introduction: Transsexualism is an inconsistency between the sex with which someone was born and the sex he or she feels belong to; therefore, these subjects want to do changes in their physical appearance that are achieved through hormonal treatment. Objective: To describe changes in the secondary sexual characteristics in patients with gender dysphoria in Cuba as a result of endocrine therapy. Methods: A study was conducted to review the clinical records in 76 patients treated by gender dysphoria in the past 15 years. It was collected the information related to socio-demographic data and some physical changes as a result of the hormonal therapy. For data analysis were obtained frequency distributions of the qualitative variables, the mean and the standard deviation of the quantitative ones. Results: The majority of patients correspond to male to female transsexuals (THM, by its acronym in Spanish). A year after, the majority of the patients already studied had a stage III or stage IV of breast development (45.3 percent) of these had stage III and 32.3 percent had stage IV). A year after the start of the attention of the 58 patients, 41.4 percent had a pattern of triangular hair typical of the female sex which they feel identified with and after 2 years it increased to 80.5 percent. After a year, there were evaluated 50 percent of all cases and at that time only 5.1 percent maintained intense facial hair, and more than half (56.8 percent) had no facial hair. At the beginning, the mean of testicular volume was 17.4 mL, after 3 months it was 15.7 mL, after 6 months was 14.3 mL and 9.7 mL after a year. Conclusions: Patients with gender dysphoria in most cases achieve changes in the secondary sexual characteristics in accordance with the sex which they feel identified with(AU)

TMJ dimensions in three-dimensional virtual models acquired through computed tomography of cone beam as sexual dimorphism / Dimensões das ATM em modelos virtuais tridimensionais obtidos por tomografia computadorizada de feixe cônico como determinantes do dimorfismo sexual

Objetivo: Este estudo objetivou relacionar as dimensões da cabeça da mandíbula com o sexo e faixa etária por meio de modelos tridimensionais obtidos por imagens de tomografia computadorizada de feixe cônico (TCFC). Material e Métodos: Foram selecionados 120 exames de TCFC pertencentes ao arquivo da Clínica de Radiologia ICT-UNESP, divididos em 04 faixas etárias, cada uma contendo 12 indivíduos de cada sexo então obtidos modelos tridimensionais virtuais e realizadas, duas medidas em cada cabeça da mandíbula: ântero-posterior (AP) e látero medial (LM). Utilizou-se teste t para amostras independentes para comparação das mensurações. Resultados: nas medidas AP apenas no lado esquerdo, entre 31 a 40 anos de idade apresentou diferença estatística entre os sexos; nas medidas LM, houve diferenças estatísticas entre os sexos em todas as faixas etárias em ambos os lados, exceto na faixa etária acima de 60 anos. Conclusão: as medidas LM das cabeças da mandíbula, independente do lado, apresentaram-se com diferenças estatisticamente significantes entre os sexos e faixas etárias, com tendência a maiores valores no sexo masculino, podendo ser um fator determinante de dimorfismo sexual.(AU)

Objective: The objective of this study was to relate the dimensions of the mandibular condyle with sex and age by means of three-dimensional models obtained by cone-beam computed tomography images (CBCT). Material and Methods: 120 CBCT examinations were selected belonging to the archives of the ICTUNESP Clinic of Radiology. They were divided into five age groups, each containing 12 individuals of each sex. Virtual three-dimensional models were then created and two measurements from each mandibular condyle were taken: anteroposterior (AP) and mediolateral (ML). The t-test was used for independent samples to compare the measurements. Results: The AP measurements only of the left side showed a statistical difference between the sexes between 31 to 40 years of age; in the ML measurements, there were statistical differences between the sexes in all age groups on both sides, except in the age group above 60 years. Conclusion: The ML measurements of the mandibular condyles, regardless of side, showed significant statistical differences between sexes and age groups, with a tendency to greater values in males, and may be a determinant factor of sexual dimorphism (AU)

Efeito de diferentes intervalos de recuperação sobre a resistência de força em indivíduos de ambos os sexos / Effect of different rest intervals on strength resistance in both sexes

O objetivo deste estudo foi analisar o desempenho motor de homens e mulheres em diferentes intervalos de recuperação em séries múltiplas a 70% de 1-RM. Quatorze indivíduos, sete homens (21,5 ± 0,6 anos; 76,2 ± 2,5 kg; 176,4 ± 6,4 cm) e sete mulheres (19,6 ± 0,7 anos; 66,3 ± 2,1 kg; 163,1 ± 6,7 cm), executaram três séries a 70% de 1-RM no exercício supino em banco horizontal e extensão de perna, com intervalos de 60 e 90 s entre as séries. Anova fatorial identificou interação significante série vs. intervalo (F = 17,56; P < 0,001) e o efeito principal do exercício (F = 7,04; P < 0,021), sem diferenças entre os sexos (F = 0,17; P = 0,691). Os resultados sugerem que a queda de desempenho motor induzida por séries múltiplas a 70% de 1-RM é semelhante em homens e mulheres, independente dos intervalos de recuperação adotados entre as séries.

The objective of this study was to analyze the motor performance of men and women at different rest intervals in multiple sets at 70% 1-RM. Fourteen individuals, seven males (21.5 ± 0.6 years, 76.2 ± 2.5 kg, 176.4 ± 6.4 cm) and seven females (19.6 ± 0.7 years, 66.3 ± 2.1 kg, 163.1 ± 6.7 cm) performed three sets at 70% 1-RM in the bench press and leg extension, with intervals of 60 and 90s between the sets. The factorial ANOVA evidenced significant interaction of set vs. rest interval (F = 17.56, P < 0.001) and the main effect of exercise (F = 7.04, P < 0.021), without differences between the sexes (F = 0.17, P = 0.691). The results suggested that the reduction in motor performance induced by multiple sets at 70% 1-RM is similar in men and women, regardless of the rest intervals between the sets.

Color pattern variation in Cichla temensis (Perciformes: Cichlidae): resolution based on morphological, molecular, and reproductive data

Morphological variants of Cichla temensis, readily differentiated by their striking color pattern differences, are found in several Amazon basin flood pulse river systems. The adult variants have at times been thought to represent different species or sexual dimorphism. A three part study was performed in two regions in Brazil (rio Igapó Açú and rio Caures) to elucidate the nature of the variants. In part one; selected diagnostic morphometric characters were compared intraspecifically among the variants and interspecifically with C. monoculus and C. orinocensis. All of the C. temensis variants were found to differ significantly from their sympatric congeners while not differing among each other. In part two, mitochondrial DNA samples were compared intraspecifically among the variants and interspecifically with their sympatric congeners. There were no diagnostic molecular synapomorphies that would unambiguously distinguish the variants and all C. temensis variants were clearly diagnosable and divergent from their sympatric congeners. In part three, color pattern variation in both sexes was compared to a gonadosomatic index (GSI). A significant correlation between color pattern variation and gonadosomatic index was found. The results of this study demonstrate that Cichla temensis variants are confirmed to be members of a single species and that the variation does not represent a sexual dimorphism. The color pattern variation is a cyclically occurring secondary sexual characteristic and is indicative of the specific degree of an individual's seasonal sexual maturation.

Variantes morfológicas de Cichla temensis, facilmente diferenciados por seus padrões de coloração marcantes, são encontrados em vários rios do sistema de inundação da várzea da bacia Amazônica. Variantes dos indivíduos adultos têm sido cogitados como pertencerem a uma diferente espécie ou apresentarem dimorfismo sexual. Um estudo em três etapas foi realizado em duas regiões no Brasil (rio Igapó Açú e rio Caures) para elucidar a natureza desta variação. Na primeira parte, caracteres morfométricos diagnósticos foram comparados intraespecificamente entre os variantes e interespecificamente com C. monoculus e C. orinocensis. Todos os variantes de C. temensis apresentaram diferenças significativas quando comparados com seus congêneres simpátricos enquanto não diferiram entre si. Na segunda parte, sequências de DNA mitocondrial foram comparadas intraespecificamente entre os variantes e interespeficamente com seus congêneres simpátricos. Não houve sinapomorfias moleculares diagnósticas para diferenciar inequivocamente os variantes e todos os variantes de C. temensis foram claramente divergentes de seus congêneres simpátricos. Na terceira parte, a variação no padrão de cor em ambos os sexos foi comparado ao índice gonadossomático (GSI). Foi encontrada uma correlação significativa entre a variação na coloração e o índice gonadossomático. Os resultados deste estudo demonstram que os variantes em Cichla temensis são membros de uma única espécie e que a variação não representa um dimorfismo sexual. A variação no padrão de cor é uma característica sexual secundária que ocorre em ciclos, sendo um indicativo do grau de maturação sexual sazonal dos indivíduos.

Causes and Clinical Characteristics of Patients with Abnormal Sex Differentiation and Development / 대한진단검사의학회지

BACKGROUND: Abnormal sex differentiation and development may present ambiguous genitalia in the newborn or lack of secondary sexual characteristics in puberty. A prompt and accurate diag-nosis should be established to minimize or avoid medical, psychological and social complications. The purpose of this study was to evaluate the causes and clinical characteristics of patients with abnormal sex differentiation and development. METHODS: We analyzed 35 patients with abnormal sex differentiation and development. Twenty patients had been considered or reared as males and fifteen patients as females. The diagnostic evaluation consisted of physical examination, hormonal analysis, sonogram, genitogram, gonadal biopsy and cytogenetics. RESULTS: Among the thirty-five patients, 11 patients were hypogonadism, 9 male pseudoherma-phroditism (5 hypospadia, 2 androgen insensitivity syndrome), 6 female pseudohermaphroditism (4 congenital adrenal hyperplasia), 4 micropenis, 4 congenital anomaly and 1 mixed gonadal dys-genesis. Gonadectomy was performed in patients with androgen insensitivity syndrome and mixed gonadal dysgenesis. Sex of rearing and gender assignment were all concordant with the known sex except one patient, who was previously reared as female and finally reassigned as male due to 5-alpha reductase deficiency. CONCLUSIONS: The causes of abnormal sex differentiation and development were variable. There-fore, an accurate diagnosis should be made by history, physical examination, radiologic and laboratory tests. Proper management and sex assignment are needed in accordance with the cause.

The Delinquency, Depression, and Anxiety Level on Timing on Expression of Secondary Sex Characteristics in Adolescents / 신경정신의학

OBJECTIVES: This survey was attempted to examine the psychological significance, such as depression, anxiety and delinquent, of pubertal changes(expressions of secondary sexual characteristics) between student and delinqent group. METHOD: Data were collected through self-report questionnaire survey over a period 12 months. Subjects served for this study consisted of 248 adolescents including 90 delinquent adolescents and 158 student adolescents in Korea, sampled from Korean middle school population and delinquent adolescent population confined in juvenile corrective institutions. The SDS & SAS were used to evaluate the state of depression & anxiety in adolescents, respectively. RESULT: 1) The early-bloomer outnumbered late-bloomer in male delinquent adolescent. 2) There were the significant differences in first experiences of masturbation, expression of pubic hair, expression of axillary hair, expression of facial hair among secondary sexual characteristics between both groups. 3) In student adolescent, there was no significant difference in anxiety, depression level between early-bloomer and late-bloomer. 4) In male delinquent adolescent, late-bloomer was significantly more anxious, depressive than early-bloomer. CONCLUSION: These findings suggest the rapid pubertal changes during adolescence have effect on delinquency, depression, anxiety, especially male. Furthermore we may assume that this preliminary results will provide useful information in understanding the psychological aspect of adolescents.