Nursing of patients with Swyer syndrome / 现代临床护理

Objective To summarize the key points of nursing the patients with simple 46 XY gonadal digenesis syndrome. Method Mental care and full preparation like nursing of the incisions , close observation of pains and nursing of adverse reactions from chemotherapy were critical for ensuring the patient′s discharge from hospital. Result All patients′height increased, secondary sex symdrome growed with armpit and pubic air growed. Conclusion Good mental nursing and targed professional nursing are critical for patients′health.

A novel mutation of SRY gene identified in a 46,XY complete gonadal dysgenesis patient / 中华内分泌代谢杂志

The clinical and genetic characteristics in a patient with 46,XY complete gonadal dysgenesis was investigated. Clinical features and laboratory data were collected from the patient and the family. The exon of SRY gene was amplified by PCR and sequenced. The patient presented with primary amenorrhea, nonambiguous female external genitalia, slight breast development, and no axillary hair or pubic hair. The female internal reproductive organs consisted of uterus and streaks of ovarian tissue. Howerver, the chromosome karyotype was 46,XY. A missense mutation of A66T in SRY gene was identified, which was not previously reported. The novel SRY mutation caused the sex reversal in this 46,XY female patient.

A Case of Swyer Syndrome Diagnosed in Infant / 대한주산의학회잡지

Swyer syndrome is characterized by a female phenotype, normal to tall stature, sexual infantilism with primary amenorrhea and 46,XY karyotype. The internal genitalia are female with uterus and full vagina, but have no ovaries or testis. Swyer syndrome is often diagnosed when young adults are evaluated for delayed puberty, as menstruation dose not occur naturally. We experienced a case of Swyer syndrome diagnosed incidentally in course of evaluating intrauterine growth retardation and delayed growth in infant. So, we report a case of Swyer syndrome with a brief review of literatures.

Two Cases of Swyer Syndrome in Sisters / 대한산부인과학회잡지

46,XY pure gonadal dysgenesis, also known as Swyer syndrome, is a disorder of sexual differentiation. Its characteristics include a female phenotype without the somatic stigmata of Turner's syndrome, primary amenorrhea, sexual infatilism and bilateral streak gonads. Neoplasia occurs in 20-30% of individuals who have gonadal dysgenesis and Y chromosomal material. Gonadoblastoma and dysgerminoma are the most frequent tumor in phenotypic females with Y chromosome. One case was referred for palpable low abdominal mass. No other somatic abnormalities could be detected. Laparotomy revealed dysgerminoma of left ovary and mesenteric metastasis. In the course of postoperative adjuvant chemotherapy, her elder sister was diagnosed as Swyer syndrome. And karyotype of this patient was 46,XY, too. So right gonadectomy was performed thereafter. The other case visited for primary amenorrhea and delayed development of breast. Physical examination revealed no development of breast, no pubic and axillary hair. External genital organ was normal shaped. Peripheral blood karyotyping was 46,XY. Bilateral gonadectomy was performed and hormone replacement therapy was started. We report two cases of Swyer syndrome and review of literature.

A Case of Dysgerminoma Associated with 46, XY Pure Gonadal Dysgenesis / 대한부인종양콜포스코피학회잡지

Dysgerminoma developed in a 21-year-old phenotypic female patient with 46,XY pure gonadal dysgenesis, Swyer syndrome. This patient presented with pelvic mass associated with abdominal pain and primay amenorrhea. Clinical characteristics showed a typical stigmata of gonadal dysgenesis: primary amenorrhea, sexual infantilism, a small uterus and left streak gonad. A 46,XY karyotype was made by lymphocyte culture. The patient was counseled to undergo operation, chemotherapy and hormon therapy. She underwent bilateral gonadectomy with total hysterectomy, partial omentectomy and multiple pelvic wall random biopsy. Histological examination revealed dysgenetic gonads with dysgerminoma. After surgery, the patient received chemotherapy and also was started on hormone replacement therapy. She is currently alive with no evidence of disease after 19 months from surgery.

A Case of Dysgerminoma with 46, XY Swyer Syndrome / 대한산부인과학회잡지

Dysgenetic streak gonads were removed laparoscopically from a phenotypic female with Swyer syndrome(ie, XY karyotype, sexual infantalism, primary amenorrhea, and Mullerian structures). Pathologic examination revealed a dysgerminoma in one of her gonads. We report a case of dysgerminoma with 46,XY Swyer syndrome and review of literature.

Analysis of SRY Gene in Korean Patients with Swyer Syndrome and their Family Members / 대한산부인과학회잡지

Individuals affected with Swyer syndrome are phenotypic females with 46, XY karyotype, sexual infantilism, mullerina derivatives, and bilateral streak gonads that may undergo neoplastic transformation. The pathogenesis of this syndrome is uncertain, but may be related to a defect in the regulation or expression of the testicular determining factor which is believed to be located on the short arm of the Y chromosome. Recently, a region termed "SRY", a single copy gene of the Y chromosome was identified as belonging to a testis-determining gene. This gene is Y-specific, highly conserved among mammals, and transcribed only in testis. The predicted amino acid sequence of SRY shares homology with DNA-binding domains of transcription factors such as chromatinassociated, nonhistone proteins HMG 1 and HMG 2. Hence, it was thought that there may be some change in SRY gene of the patients with Swyer syndrome. And it was reported in some cases that there was deletion or mutation in the gene, but no abnormality of SRY gene was observed in other cases. So, it is a new approach to understand the mechanism of the human sexual differentiation to investigate this syndrome in terms of DNA sequence of SRY gene. To verify the presence or absence of SRY, or the change in SRY, we performed polymerase chain reaction and DNA sequencing of the conserved region of SRY gene from four patients with Swyer syndrome and their family members. The results are as follows. 1) Four patients with Swyer syndrome, their father, and two normal male control were positive whereas two female control were negative for the band that represents the coding sequence of SRY. 2) The DNA sequences of SRY gene from four patients with Swyer syndrome, their father, and two normal male control were the same, and there was no deletion or mutation in the gene. In conclusion, there may be complex sex determining cascade including other genes not only on the Y chromosome, but also on the X chromosome or even autosome in human sexual differentiation.