Desarrollo y validación de la versión abreviada del Transsexual Voice Questionnaire for Male-to-Female Transsexuals en español

ObjectiveThe aim of this study was to create and validate an abbreviated version of the Spanish Transsexual Voice Questionnaire for Male-to-Female Transsexuals (SvTVQ^MtF).SettingThe study was conducted by two referral hospitals for voice feminization surgery and by a university department of psychology and speech therapy, all in Spain.Subjects and methodsWe prospectively studied 51 male-to-female transsexuals who underwent voice feminization surgery between January 2017 and December 2018. The SvTVQ^MtF was completed before and after surgery, and the 10 items with the greatest variation were selected by clinical consensus of an expert panel to develop the short version of the SvTVQ^MtF (SvTVQ^MtF-10). The correlation between the total score and the score for each item on the SvTVQ^MtF and the SvTVQMtF-10 was studied. The internal consistency of the SvTVQ^MtF-10 was analysed.ResultsGood correlation (Pearson coefficient above .90) was found between the two questionnaires. A significant correlation was found between the total SvTVQ^MtF-10 score and the score for each item. A significant negative correlation was found between the SvTVQ^MtF and fundamental frequency after voice feminization surgery. Cronbach's α was .79.ConclusionThe SvTVQ^MtF-10 is a valid short version of the SvTVQ^MtF and can be used to quantify voice-related quality of life in MtF transsexuals.     

Fronto-orbital feminization technique. A surgical strategy using fronto-orbital burring with or without eggshell technique to optimize the risk/benefit ratio

The demand for facial feminization is increasing in transsexual patients. Masculine foreheads present extensive supraorbital bossing with a more acute glabellar angle, whereas female foreheads show softer features. The aim of this article is to describe our surgical technique for fronto-orbital feminization. The mask-lift technique is an upper face-lift. It provides rejuvenation by correcting collapsed features, and fronto-orbital feminization through burring of orbital rims and lateral canthopexies. Depending on the size of the frontal sinus and the thickness of its anterior wall, frontal remodeling is achieved using simple burring or by means of the eggshell technique. Orbital remodeling comprises a superolateral orbital opening, a reduction of ridges and a trough at the lateral orbital rim to support the lateral canthopexy. Frontal, corrugator and procerus myectomies, plus minimal scalp excision, complete the surgery. Our technique results in significant, natural-looking feminization. No complications were observed in our series of patients. The eggshell technique is an alternative to bone flap on over-pneumatized sinus. Fronto-orbital feminization fits into a wider surgical strategy. It can be associated to rhinoplasty, genioplasty, mandibular angle remodeling, face lift and laryngoplasty. Achieving facial feminization in 2 or 3 stages improves psychological and physiological tolerance.     

Bilateral incipient germ cell tumours of the testis in the incomplete testicular feminization syndrome

The presence of bilateral incipient germ cell tumours in the testes of two cases of the incomplete testicular feminization syndrome (TFS) is reported and found to resemble that occurring in the testes of infertile men. Both the nature and nomenclature of the lesion is discussed, as is its relevance in the early diagnosis and improved therapy of testicular tumours, which occur frequently in TFS. Suggestions are made for a more complete postpubertal surveillance in these patients, including assay of tumour markers and bilateral biopsies in cases of complete TFS. In this condition the removal of the testes is usually delayed until the twenties when total feminization is achieved, thus increasing the chances of tumour development.     

Testicular feminization syndrome (TFS) associated with paragonadal cysts

This report describes a case of testicular feminization discovered at the age of 74 and associated with a malformation consisting of three large paratesticular cysts, interpreted as dilated remnants of the epididymis.     

沃尔巴克氏体对靶标昆虫的作用及生防潜能

沃尔巴克氏体 (Wolbachia)为广泛分布于节肢动物生殖组织内的一类共生细菌 ,通过卵细胞质传播并参与宿主多种生殖活动的调控 ,包括诱导生殖不亲和、孤雌生殖、雌性化和杀雄作用等。本文较全面地分析了Wolbachia的形态分类、分布、对靶标昆虫的生殖调控及生防潜能 ,并对未来的研究趋势进行了探讨     

2例睾丸女性化综合征患者雄激素受体基因中的突变

目的：研究２例完全型睾丸女性化综合征（ＴＦＭ）患者的外阴部皮肤成纤维细胞（ＧＳＦ）中的雄激素受体（ＡＲ）。结果：发现两患者ＡＲ的数量无明显改变，但一患者的ＡＲ亲和力明显降低。用ＰＣＲ－ＳＳＣＰ（单链构象多态性）方法对两患者ＡＲ基因８个外显子中的７个（Ｂ－Ｈ）分别进行分析，发现两患者ＡＲ基因外显子Ｅ均存在着泳动变位，ＤＮＡ序列分析证实两患者外显子Ｅ各有一点突变，分别使得编码第７４３位和第７５２位的氨基酸发生了改变，后一突变还造成了一Ｓａｕ３ＡⅠ酶酶切位点的消失。结论：结合ＡＲ功能改变及临床表型可以认为，两患者的性分化发育异常是由于两位点的突变所致     

睾丸女性化综合征的研究进展

睾丸女性化综合征是一种X连锁的隐性遗传病,为男性假两性畸形中最常见的类型.患者染色体核型46,XY,性腺为睾丸,雄激素合成正常,但由于雄激素受体基因的突变,导致功能正常的雄激素受体减少或缺失,最终形成临床上从几乎正常男性到几乎正常女性的广泛表型.因为发育异常的睾丸存在恶变可能,目前普遍认为应该首选睾丸切除术,但在手术时机的选择上还存在着很多争议.该文主要从发病的分子机制以及手术方式,手术时机的选择方面进行综述.     

两性畸形14例分析

14例两性畸形,13例接受手术治疗,其中2例更改社会性别。侧重讨论了治疗并建议将两性畸形分为三类。