• Advances in pediatric surgery
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• 제13권2호
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• pp.222-227
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• 2007

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.

• Clinical and Experimental Reproductive Medicine
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• 제10권2호
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• pp.25-37
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• 1983

As the cytogenetic developed, cytogenetic study has also developed progressively. This study is a systematical cytogenetic and clinico-hormonal analysis of 20 cases Wp.ere gonadal dysgenesis was diagnosed and deferred to the Dept. of obstetrics and Gynecology, Yonsei University, Medical School from Jan. 1974 to Aug. 1983. Twenty patients with the diagnosis of gonada dysgenesis have been assesed as to possible correlations between clinical, homonal and cytogenic findings. The desults were as follows; l. Gonadal dysgenesis were found in 20 cases, consisting of 15 cases (75%) of turnurs syndrome, 4 case of pure gonadal dysgenesis (20%), 46. XX and 1 case of mixed gonadal dysgenesis, 45,XO/46,XY. 2. Patients with XO karyotype, turner's ryndorme, have a resonably constant clinical picture of sexual infantilism with streak gonads, short status and webbed neck. 3. 17 cases were found primary amenorhea and two cases were noted with 2 ndary amenorrhea. one case has been presented with menstruation. 4. The rudimentary streak gonads were found in 7 cases of 8 cases and one case has a rudimentary streak gonad on one side and a testis on the contralateral side. 5. The study showed that potients with gonadal dysgenesis had an average of about 4-8 times higher basal FSH and about 3-7 times higher basal LH than that of the early follicular phase of normal menstrual cycle. 6. Two cases of three gonadal dysgenesis patieats, who performed LH-RH challage test, showed that the serum FSH levels reached the maximal level at 30 min after injection of CHRH and the serum LH level reached the maximal level at 60 min ofter injection of LHRH one case showed no significant response to LH-RH injection. Thus, bu studying simultoneously the clinical, cytogenic, hormonal aspects and visualization of gonads, we have gained some practical insight into the requirements for proper disgnosis and treatment.

• Clinical and Experimental Reproductive Medicine
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• 제13권2호
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• pp.153-159
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• 1986

The high rate of chromosomal abnormalities in patients with primary amenorrhea implies the need for routine screening for chromosomal abnormalities among such patients. This study was designed for the cytogenetic analysis of 236 patients with primary amenorrhea, which was referred to Yonsei University Medical Center, from January, 1, 1974 to December, 31, 1985. The results were as follows: 1. Of the 236 patients, 145 cases (61.4%) showed normal karyotype, and 91 cases (38.6%) showed chromosomal abnormalities. 2. Gonadal dysgenesis was found in 56 cases, consisting of 42 cases, Turner's syndrome, 12 cases, pure gonadal dysgenesis, and 2 cases mixed gonadal dysgenesis. a) Turner's syndrome was found in 42 cases, consisting of 18 cases of 45, X and 24 cases of mosaicism. b) Pure gonadal dysgenesis was found in 12 cases, consisting of 10 cases of 46, XX and 2 cases of 46, XY. c) Mixed gonadal dysgenesis was found in 2 cases, consisting of 1 case of 46, XY and 1 case of 45, X/46, XY. 3. Intersex was found in 80 cases, consisting of 35 cases of 46, XX, and 45 cases of 46, XY. 4. Congenital anomalies of reproductive system was found in 82 cases and all cases were normal karyotype.

• Clinical and Experimental Pediatrics
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• 제48권12호
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• pp.1317-1323
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• 2005

목 적 : 성염색체이상증후군은 사춘기 이후 이차 성징의 결여로 그 증상이 뚜렷해지므로 사춘기 이전의 진단은 쉽지 않다. 본 연구는 성염색체이상증후군의 빈도, 진단시 연령, 그리고 임상적 특징을 조사하여 그 의의를 알아보고자 한다. 방 법 : 1981년 2월부터 2001년 8월까지 20년 동안 경북대학교병원 소아과 염색체검사실에 의뢰된 염색체검사 중 성염색체 이상증후군으로 진단된 115례 환자의 임상적 특징, 진단시 연령 그리고 핵형 분석을 후향적인 방법으로 조사하였다. 결 과 : 성염색체이상증후군의 종류와 빈도는 Klinefelter 증후군은 52%, Turner 증후군은 42%, XXX 증후군은 3%, 혼합 성선이형성은 3%였다. Klinefelter 증후군은 47,XXY가 97%, mosaicism이 3%였고, Turner 증후군은 45,X가 67%, mosaicism이 23%, X 염색체의 구조적 이상은 10%였다. XXX 증후군은 47,XXX가 67%, mosaicism은 33%였고, 혼합 성선이형성은 모두 45,X/46,XY였다. 성염색체이상증후군의 81%가 사춘기 이후에 진단되었다. 신생아기에 Klinefelter 증후군과 Turner 증후군으로 진단받은 경우는 표현형이 정상이거나 경한 선천성기형만을 보였다. Turner 증후군과 Klinefelter 증후군의 mosaicism이나 구조적 이상군에서 전형적인 45,X나 47,XXY보다 신체상 증상 발현이 경미할 것으로 생각되었으나 본 연구에서는 통계학적으로 유의한 차이는 보이지 않았다. 결 론 : 성염색체이상증후군은 사춘기 이전에는 그 증상이 뚜렷하지 않으므로 환아에 대한 주의 깊은 관찰과 관심으로 조기에 진단하여 정상적인 정신성적발달과 성장발육 및 성생활을 유지하도록 부모와 환아의 질환에 대한 인지도를 높여야 할 것으로 사료된다. 특히 핵형 분석시 Turner 증후군은 X염색체의 다양한 구조 이상 또는 mosaicism의 빈도가 높기 때문에 핵형 분석시 이를 염두에 두어야 한다.

• 대한임상검사과학회지
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• 제42권3호
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• pp.111-115
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• 2010

A 15-year-old female with primary amenorrhea and Tuner's syndrome feature was referred for a chromosome analysis. The karyotype of the patient was 45,X/46,X,der(Y) mosaicism under initial GTG-banding analysis. Fluorescence in situ hybridization (FISH) analysis with probe for CEP X probes and SRY probe (Vysis, Inc. Downers Grove, IL 60515, USA) was carried out. This probe is direct labeled with SpectrumOrange (SRY, Yp11.3) and is available as a single probe or mixed with the CEP X SpectrumGreen probe. SRY SpectrumOrange/CEP X SpectrumGreen hybridized to a specimen obtained from an two isodicentric Y chromosomes. The karyotype of the patient was ish Xcen(DXZ1x1)/Xcen(DXZ1x1), Yp11.3(SRYx2) by using FISH. This karyotype was considered a variant of Tuner syndrome with mixed gonadal dysgenesis (MGD), male pseudohermaphroitism (MPH) and apparently normal male.