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The Manila clam Ruditapes philippinarum on the west coast of Korea harbors several digenetic trematodes. However, most studies in this region have been restricted to a few sampling sites and the current species designation of some trematodes is largely based on morphology, leaving the molecular phylogenetic position among the Digenea unsolved. Thus, we first provide both morphology and molecular phylogeny of some components in the trematodes community in the Manila clam based on a large-scale survey of 26 sites on the west coast, where well-developed tidal flats serve as large commercial clam culture beds. Our study revealed that the trematodes community in the clams consisted of at least 5 species that belong to 3 families (Himasthlidae, Gymnophallidae, Baccigeridae) and 1 superfamily (Monorchioidea). The life mode of the 5 different species included the metacercaria and sporocyst, with one species (Parvatrema duboisi) utilizing the clams as both the first and/or second intermediate host. Trematode infection prevalences were not evenly distributed among the study sites, although the reasons behind this are yet to be determined. Morphological identification was confirmed with the molecular analyses based on ITS and 28S rDNA; phylogenetic analysis also revealed that Cercaria pectinata infecting the clam gonad should be referred to as Bacciger bacciger hereafter. The present preliminary study provides a crucial baseline that could be further developed in a future study on the digenean trematodes community in the Manila clam.
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Multisystemic inflammatory syndrome in children (MIS-C) might manifest in a broad spectrum of clinical scenarios, ranging from mild features to multi-organ dysfunction and mortality. However, this novel entity has a heterogenicity of data regarding prognostic factors associated with severe outcomes. The present study aimed to identify independent predictors for severity by using multivariate regression models. A total of 391 patients (255 boys and 136 girls) were admitted to Vietnam National Children's Hospital from January 2022 to June 2023. The median age was 85 (range: 2-188) months, and only 12 (3.1%) patients had comorbidities. 161 (41.2%) patients required PICU admission, and the median PICU LOS was 4 (2-7) days. We observed independent factors related to PICU admission, including CRP ≥ 50 (mg/L) (OR 2.52, 95% CI 1.39-4.56, p = 0.002), albumin ≤ 30 (g/L) (OR 3.18, 95% CI 1.63-6.02, p = 0.001), absolute lymphocyte count ≤ 2 (× 109/L) (OR 2.18, 95% CI 1.29-3.71, p = 0.004), ferritin ≥ 300 (ng/mL) (OR 2.35, 95% CI 1.38-4.01), p = 0.002), and LVEF < 60 (%) (OR 2.48, 95% CI 1.28-4.78, p = 0.007). Shock developed in 140 (35.8%) patients, especially for those decreased absolute lymphocyte ≤ 2 (× 109/L) (OR 2.48, 95% CI 1.10-5.61, p = 0.029), albumin ≤ 30 (g/L) (OR 2.53, 95% CI 1.22-5.24, p = 0.013), or LVEF < 60 (%) (OR 2.24, 95% CI 1.12-4.51, p = 0.022). In conclusion, our study emphasized that absolute lymphocyte count, serum albumin, CRP, and LVEF were independent predictors for MIS-C severity. Further well-designed investigations are required to validate their efficacy in predicting MIS-C severe cases, especially compared to other parameters. As MIS-C is a new entity and severe courses may progress aggressively, identifying high-risk patients optimizes clinicians' follow-up and management to improve disease outcomes.
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COVID-19 , Índice de Gravidade de Doença , Síndrome de Resposta Inflamatória Sistêmica , Humanos , Masculino , Feminino , Criança , COVID-19/epidemiologia , COVID-19/diagnóstico , COVID-19/complicações , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Vietnã/epidemiologia , Pré-Escolar , Adolescente , Lactente , SARS-CoV-2/isolamento & purificação , Prognóstico , Contagem de Linfócitos , Unidades de Terapia Intensiva Pediátrica , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismoRESUMO
Two planthopper species of the family Nogodinidae are added to the fauna of Vietnam, both from two localities in Thua Thien-Hue Province: Bach Ma National Park and Phong Dien District. The first species belongs to Goniopsarites Meng, Wang & Wang, 2014, G.mientrunganus Constant & Pham, sp. nov., and the second belongs to Pisacha Distant, 1906, P.yinggensis Meng, Wang & Wang, 2014. Pisachayinggensis was previously recorded from Hainan Island, China. These new records greatly extend the distribution of both genera, which were known from southern China, Hainan and North Vietnam, to the south, reaching the mid area of Central Vietnam. Sexual dimorphism is reported in P.yinggensis for the first time. Illustrations of habitus and male terminalia of the new species are given as well as distribution maps and photographs of live specimens and their habitat. The family Nogodinidae now comprises nine species in Vietnam, with three of them present in Bach Ma National Park.
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Wiskott-Aldrich syndrome (WAS) is a severe X-linked primary immunodeficiency resulting from a diversity of mutations distributed across all 12 exons of the WAS gene. WAS encodes a hematopoietic-specific and developmentally regulated cytoplasmic protein (WASp). The objective of this study was to develop a gene correction strategy potentially applicable to most WAS patients by employing nuclease-mediated, site-specific integration of a corrective WAS gene sequence into the endogenous WAS chromosomal locus. In this study, we demonstrate the ability to target the integration of WAS2-12-containing constructs into intron 1 of the endogenous WAS gene of primary CD34+ hematopoietic stem and progenitor cells (HSPCs), as well as WASp-deficient B cell lines and WASp-deficient primary T cells. This intron 1 targeted integration (TI) approach proved to be quite efficient and restored WASp expression in treated cells. Furthermore, TI restored WASp-dependent function to WAS patient T cells. Edited CD34+ HSPCs exhibited the capacity for multipotent differentiation to various hematopoietic lineages in vitro and in transplanted immunodeficient mice. This methodology offers a potential editing approach for treatment of WAS using patient's CD34+ cells.
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A new compound, conamonin A (1), was isolated from the whole plants of Conamomum rubidum with eight known dihydrochalcones (2-9). Their structures were elucidated by a combination of spectroscopic methods as well as by comparison with previously reported data. The absolute configuration of 1 was assigned by TDDFT-ECD method. Compounds 1 and 8 showed inhibitory activity against LPS-induced NO production in the RAW 264.7 cells, with IC50 values of 58.29 ± 2.88 and 81.77 ± 5.99 µM, respectively. Compounds 3/4 and 5/6 exhibited inhibitory effects, with IC50 values of 28.76 ± 1.16 and 29.89 ± 1.79 µg/mL, respectively. Compounds 2, 7-9 exhibited significant cytotoxic activity against human lung carcinoma (the SK-LU-1 cell line) with IC50 values ranging from 9.87 to 17.99 µM. This study offers valuable insights into the chemical constituents and biological activities of Conamomum rubidum, highlighting its potential as a source for discovering new anti-inflammatory and cytotoxic agents.
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Conducting polymers (CPs) are an innovative class of materials recognized for their high flexibility and biocompatibility, making them an ideal choice for health monitoring applications that require flexibility. They are active in their design. Advances in fabrication technology allow the incorporation of CPs at various levels, by combining diverse CPs monomers with metal particles, 2D materials, carbon nanomaterials, and copolymers through the process of polymerization and mixing. This method produces materials with unique physicochemical properties and is highly customizable. In particular, the development of CPs with expanded surface area and high conductivity has significantly improved the performance of the sensors, providing high sensitivity and flexibility and expanding the range of available options. However, due to the morphological diversity of new materials and thus the variety of characteristics that can be synthesized by combining CPs and other types of functionalities, choosing the right combination for a sensor application is difficult but becomes important. This review focuses on classifying the role of CP and highlights recent advances in sensor design, especially in the field of healthcare monitoring. It also synthesizes the sensing mechanisms and evaluates the performance of CPs on electrochemical surfaces and in the sensor design. Furthermore, the applications that can be revolutionized by CPs will be discussed in detail.
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Técnicas Biossensoriais , Nanoestruturas , Polímeros/química , Técnicas Biossensoriais/métodos , Tecnologia , CarbonoRESUMO
BACKGROUND: Cells are sensitive to changes in gravity, especially the cytoskeletal structures that determine cell morphology. The aim of this study was to assess the effects of simulated microgravity (SMG) on 3T3 cell morphology, as demonstrated by a characterization of the morphology of cells and nuclei, alterations of microfilaments and microtubules, and changes in cycle progression. METHODS: 3T3 cells underwent induced SMG for 72 h with Gravite®, while the control group was under 1G. Fluorescent staining was applied to estimate the morphology of cells and nuclei and the cytoskeleton distribution of 3T3 cells. Cell cycle progression was assessed by using the cell cycle app of the Cytell microscope, and Western blot was conducted to determine the expression of the major structural proteins and main cell cycle regulators. RESULTS: The results show that SMG led to decreased nuclear intensity, nuclear area, and nuclear shape and increased cell diameter in 3T3 cells. The 3T3 cells in the SMG group appeared to have a flat form and diminished microvillus formation, while cells in the control group displayed an apical shape and abundant microvilli. The 3T3 cells under SMG exhibited microtubule distribution surrounding the nucleus, compared to the perinuclear accumulation in control cells. Irregular forms of the contractile ring and polar spindle were observed in 3T3 cells under SMG. The changes in cytoskeleton structure were caused by alterations in the expression of major cytoskeletal proteins, including ß-actin and α-tubulin 3. Moreover, SMG induced 3T3 cells into the arrest phase by reducing main cell cycle related genes, which also affected the formation of cytoskeleton structures such as microfilaments and microtubules. CONCLUSIONS: These results reveal that SMG generated morphological changes in 3T3 cells by remodeling the cytoskeleton structure and downregulating major structural proteins and cell cycle regulators.
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Ausência de Peso , Camundongos , Animais , Citoesqueleto/metabolismo , Citoesqueleto de Actina/metabolismo , Microtúbulos/metabolismo , Células 3T3RESUMO
Genus Penicillium comprising the most important and extensively studied fungi has been well-known as a rich source of secondary metabolites. Our study aimed to analyze and investigate biological activities, including in vitro anti-cancer, anti-inflammatory and anti-diabetic properties, of metabolites from a marine-derived fungus belonging to P. levitum. The chemical compounds in the culture broth of P. levitum strain N33.2 were extracted with ethyl acetate. Followingly, chemical analysis of the extract leaded to the isolation of three ergostane-type steroid components, namely cerevisterol (1), ergosterol peroxide (2), and (3ß,5α,22E)-ergosta-6,8(14),22-triene-3,5-diol (3). Among these, (3) was the most potent cytotoxic against human cancer cell lines Hep-G2, A549 and MCF-7 with IC50 values of 2.89, 18.51, and 16.47 µg/mL, respectively, while the compound (1) showed no significant effect against tested cancer cells. Anti-inflammatory properties of purified compounds were evaluated based on NO-production in LPS-induced murine RAW264.7 macrophages. As a result, tested compounds performed diverse inhibitory effects on NO production by the macrophages, with the most significant inhibition rate of 81.37 ± 1.35% at 25 µg/mL by the compound (2). Interestingly, compounds (2) and (3) exhibited inhibitory activities against pancreatic lipase and α-glucosidase enzymes in vitro assays. Our study brought out new data concerning the chemical properties and biological activities of isolated steroids from a P. levitum fungus.
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A complex crystallization behavior was observed for the alternating copolymer DMDS-alt-DVE synthesized via thiol-ene step-growth polymerization. Understanding the underlying complex crystallization processes of such innovative polythioethers is critical for their application, for example, in polymer coating technologies. These alternating copolymers have polymorphic traits, resulting in different phases that may display distinct crystalline structures. The copolymer DMDS-alt-DVE was studied in an earlier work, where only two crystalline phases were reported: a low melting, L - Tm, and high melting, H - Tm phase. Remarkably, the H - Tm form was only achieved by the previous formation and melting of the L - Tm form. We applied calorimetric techniques encompassing seven orders of magnitude in scanning rates to further explore this complex polymorphic behavior. Most importantly, by rapidly quenching the sample to temperatures well below room temperature, we detected an additional polymorphic form (characterized by a very low melting phase, denoted VL - Tm). Moreover, through tailored thermal protocols, we successfully produced samples containing only one, two, or all three polymorphs, providing insights into their interrelationships. Understanding polymorphism, crystallization, and the resulting morphological differences can have significant implications and potential impact on mechanical resistance and barrier properties.
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A list of 10 species from three subfamilies of Tetrigidae from Bach Mã National Park in the province of Thua Thiên-Hue, Vietnam is presented here. Eight of which are new for the national park. Among these, two new species are described: Miriatroides luna Tan & Storozhenko, sp. nov. and Rhopalina bachma Tan & Storozhenko, sp. nov. New synonymy is proposed: Systolederus cinereus Brunner von Wattenwyl, 1893 = Systolederus ridleyi Hancock, 1909, syn. nov. Three species are also recorded in Vietnam for the first time: Tegotettix bufocrocodil (Storozhenko & Dawwrueng, 2015) previously known from Thailand and Cambodia, Zhengitettix albitarsus Storozhenko, 2013 so far considered as endemic to Thailand, and Systolederus cinereus widely distributed in Southeast Asia.
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Gafanhotos , Ortópteros , Animais , Vietnã , Parques RecreativosRESUMO
Two new planthopper species of the tropiduchid genus Connelicita Wang & Bourgoin, 2015, C.bachmaensis Constant & Pham, sp. nov., and C.phongdienensis Constant & Pham, sp. nov. are described from Bach Ma National Park and from the Centre for Conservation of Vietnam Natural Resources and Rescue of Animals and plants, Phong Dien District in Thua Thien-Hue Province, respectively. These new records greatly extend the distribution of the genus, which was known from southern China (Guangxi) and North Vietnam, to the south, reaching the mid area of Central Vietnam. New records are provided for C.haiphongensis Wang & Zhang, 2015, extending the distribution of the species from Cat Ba Island to a large zone in North Vietnam. Illustrations of habitus, details, and male genitalia are given as well as a distribution map and photographs of the habitat. An identification key to the species of Vietnam is provided. The genus Connelicita now comprises five species.
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Osteoporosis contributes significantly to health and economic burdens worldwide. However, the development of osteoporosis-related prediction tools has been limited for lower-middle-income countries, especially Vietnam. This study aims to develop prediction models for the Vietnamese population as well as evaluate the existing tools to forecast the risk of osteoporosis and evaluate the contribution of covariates that previous studies have determined to be risk factors for osteoporosis. The prediction models were developed to predict the risk of osteoporosis using machine learning algorithms. The performance of the included prediction models was evaluated based on two scenarios; in the first one, the original test parameters were directly modeled, and in the second the original test parameters were transformed into binary covariates. The area under the receiver operating characteristic curve, the Brier score, precision, recall and F1-score were calculated to evaluate the models' performance in both scenarios. The contribution of the covariates was estimated using the Permutation Feature Importance estimation. Four models, namely, Logistic Regression, Support Vector Machine, Random Forest and Neural Network, were developed through two scenarios. During the validation phase, these four models performed competitively against the reference models, with the areas under the curve above 0.81. Age, height and weight contributed the most to the risk of osteoporosis, while the correlation of the other covariates with the outcome was minor. Machine learning algorithms have a proven advantage in predicting the risk of osteoporosis among Vietnamese women over 50 years old. Additional research is required to more deeply evaluate the performance of the models on other high-risk populations.
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Aprendizado de Máquina , Osteoporose , Humanos , Feminino , Idoso , Pessoa de Meia-Idade , Vietnã/epidemiologia , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Fatores de Risco , Povo AsiáticoRESUMO
Matsumurasca onukii (Matsuda, R. (1952). Oyo-Kontyu Tokyo, 8(1): 19-21), one of the dominant pests in major tea production areas in Asia, currently is known to occur in Japan, Vietnam, and China, and severely threatens tea production, quality, and international trade. To elucidate the population genetic structure of this species, 1633 single nucleotide polymorphisms (SNPs) and 18 microsatellite markers (SSRs) were used to genotype samples from 27 sites representing 18 geographical populations distributed throughout the known range of the species in East Asia. Analyses of both SNPs and SSRs showed that M. onukii populations in Yunnan exhibit high-genetic differentiation and structure compared with the other populations. The Kagoshima (JJ) and Shizuoka (JS) populations from Japan were separated from populations from China by SNPs, but clustered with populations from Jinhua (JH), Yingde (YD), Guilin (GL), Fuzhou (FZ), Hainan (HQ), Leshan (CT), Chongqing (CY), and Zunyi (ZY) tea plantations in China and the Vietnamese Vinh Phuc (VN) population based on the SSR data. In contrast, CT, CY, ZY, and Shaanxi (SX) populations clustered together based on SNPs, but were separated by SSRs. Both marker datasets identified significant geographic differentiation among the 18 populations. Various environmental and anthropogenic factors, including geographical barriers to migration, human transport of hosts (Camellia sinesis [L.] O. Kuntze) and adaptation of M. onukii to various local climatic zones possibly account for the rapid spread of this pest in Asia. The results demonstrate that SNPs from high-throughput genotyping data can be used to reveal subtle genetic substructure at broad scales in r-strategist insects.
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Between 2010 and 2015, nocardiosis outbreaks caused by Nocardia seriolae affected many permit farms throughout Vietnam, causing mass fish mortalities. To understand the biology, origin and epidemiology of these outbreaks, 20 N. seriolae strains collected from farms in four provinces in the South Central Coast region of Vietnam, along with two Taiwanese strains, were analysed using genetics and genomics. PFGE identified a single cluster amongst all Vietnamese strains that was distinct from the Taiwanese strains. Like the PFGE findings, phylogenomic and SNP genotyping analyses revealed that all Vietnamese N. seriolae strains belonged to a single, unique clade. Strains fell into two subclades that differed by 103 SNPs, with almost no diversity within clades (0-5 SNPs). There was no association between geographical origin and subclade placement, suggesting frequent N. seriolae transmission between Vietnamese mariculture facilities during the outbreaks. The Vietnamese strains shared a common ancestor with strains from Japan and China, with the closest strain, UTF1 from Japan, differing by just 220 SNPs from the Vietnamese ancestral node. Draft Vietnamese genomes range from 7.55 to 7.96 Mbp in size, have an average G+C content of 68.2â% and encode 7â602-7958 predicted genes. Several putative virulence factors were identified, including genes associated with host cell adhesion, invasion, intracellular survival, antibiotic and toxic compound resistance, and haemolysin biosynthesis. Our findings provide important new insights into the epidemiology and pathogenicity of N. seriolae and will aid future vaccine development and disease management strategies, with the ultimate goal of nocardiosis-free aquaculture.
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Doenças dos Peixes , Nocardiose , Animais , Aquicultura , Doenças dos Peixes/epidemiologia , Doenças dos Peixes/genética , Genômica , Nocardia , Nocardiose/epidemiologia , Nocardiose/veterinária , Vietnã/epidemiologiaRESUMO
The baseline data of radioactivity levels in food is one of the main factors for the assessment of resident's health risk. Gross beta and alpha activity was identified for selected commercial freshwater fish species, including 29 types of fish species by a gas-flow proportional detector. The samples were collected from wholesale markets in Hanoi city, Vietnam. The highest gross alpha activity was recorded in blotched snakehead, a pelagic and carnivorous species, and the lowest one was recorded in common carp, a demersal and omnivorous species. Meanwhile, the gross beta activity was much higher than the gross alpha activity with the highest value of gross beta, observed in Wels catfish, a demersal and carnivorous species, and the lowest one found in Mudskipper a demersal, herbivores species. Regarding feeding types, the gross alpha activity was observed in the order of Alcarnivores > Alomnivores > Alherbivores whereas the gross beta was non-distinction. In terms of living behavior, the gross alpha activity in pelagic species was much higher than that in demersal species (Alpelagic > > Aldemersal) and indifferent for gross beta. There was an insignificant relationship between the trophic level with gross beta and alpha activities in freshwater fish species. The calculated annual effective dose ââranged from 0.19 to 1.88 and 0.78 mSv.y-1 on average, being within the limited dose for the public as reported by UNSCEAR in which gross beta activity has a strong correlation with the total annual effective dose.
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Peixes , Água Doce , Animais , VietnãRESUMO
Extracellular matrix components such as collagens are deposited within the tumor microenvironment at primary and metastatic sites and are recognized to be critical during tumor progression and metastasis development. This study aimed to evaluate the clinical and prognostic impact of Discoidin Domain Receptor 1 (DDR1) expression in colon cancers and its association with a particular molecular and/or morphological profile and to evaluate its potential role as a prognosis biomarker. Immunohistochemical expression of DDR1 was evaluated on 292 colonic adenocarcinomas. DDR1 was highly expressed in 240 (82.2%) adenocarcinomas. High DDR1 immunostaining score was significantly associated, on univariate analysis, with male sex, left tumor location, BRAF wild type status, KRAS mutated status, and Annexin A10 negativity. High DDR1 immunohistochemical expression was associated with shorter event free survival only. Laser capture microdissection analyses revealed that DDR1 mRNA expression was mainly attributable to adenocarcinoma compared to stromal cells. The impact of DDR1 expression on cell invasion was then evaluated by modified Boyden chamber assay using cell types with distinct mutational profiles. The invasion capacity of colon adenocarcinoma is supported by DDR1 expression. Thus, our results showed that DDR1 was highly expressed in most colon adenocarcinomas and appears as an indicator of worse event free survival.
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Sickle cell disease (SCD) is a genetic disorder that affects millions around the world. Enhancement of fetal γ-globin levels and fetal haemoglobin (HbF) production in SCD patients leads to diminished severity of many clinical features of the disease. We recently identified the transcriptional co-activator PGC-1α as a new protein involved in the regulation of the globin genes. Here, we report that upregulation of PGC-1α by infection with a lentivirus expressing PGC-1α or by the small-molecule PGC-1α agonist ZLN005 in human primary erythroid progenitor CD34+ cells induces both fetal γ-globin mRNA and protein expression as well as the percentage of HbF-positive cell (F cells) without significantly affecting cell proliferation and differentiation. We further found that the combination of ZLN005 and hydroxyurea (hydroxycarbamide) exhibited an additive effect on the expression of γ-globin and the generation of F cells from cultured CD34+ cells. In addition, ZLN005 induced robust expression of the murine embryonic ßh1-globin gene and to a lesser extent, human γ-globin gene expression in sickle mice. These findings suggest that activation of PGC-1α by ZLN005 might provide a new path for modulating HbF levels with potential therapeutic benefit in ß-hemoglobinopathies.
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Anemia Falciforme , Hemoglobinopatias , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/metabolismo , Anemia Falciforme/tratamento farmacológico , Anemia Falciforme/genética , Animais , Hemoglobina Fetal/metabolismo , Expressão Gênica , Regulação da Expressão Gênica , Humanos , Camundongos , gama-Globinas/genéticaRESUMO
A photocatalytic thiol-ene aqueous emulsion polymerization under visible-light is described to prepare linear semicrystalline latexes using 2,2'-dimercaptodiethyl sulfide as dithiol and various dienes. The procedure involves low irradiance (3 mW cm-2 ), LED irradiation source, eosin-Y disodium as organocatalyst, low catalyst loading (<0.05% mol), and short reaction time scales (<1 h). The resulting latexes have molecular weights of about 10 kg mol-1 , average diameters of 100 nm, and a linear structure consisting only of thioether repeating units. Electron-transfer reaction from a thiol to the triplet excited state of the photocatalyst is suggested as the primary step of the mechanism (type I), whereas oxidation by singlet oxygen generated by energy transfer has a negligible effect (type II). Only polymers prepared with aliphatic dienes such as diallyl adipate or di(ethylene glycol) divinyl ether exhibit a high crystallization tendency as revealed by differential scanning calorimetry, polarized optical microscopy, and X-ray diffraction. Ordering and crystallization are driven by molecular packing of poly(thioether) chains combining structural regularity, compactness, and flexibility.
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Compostos de Sulfidrila , Sulfetos , Emulsões , Polimerização , Polímeros/química , Compostos de Sulfidrila/químicaRESUMO
Female genitourinary treatments in aesthetics utilize energy-based treatments and other noninvasive modalities. These include CO2 and Erbium YAG lasers, radiofrequency, high-intensity focused electromagnetic energy, hyaluronic acid injection, platelet-rich plasma, and silicone thread treatments with an objective to treat sexual dysfunction and symptoms of genitourinary syndrome associated with menopause, which include atrophic vaginitis, urinary incontinence, and vulvovaginal laxity that is characterized by vaginal dryness, thinning of the epithelium, laxity, prolapse, incontinence, dyspareunia, and increased bacterial infections. The body of evidence is growing for the use of these modalities to improve signs and symptoms of the genitourinary syndrome associated with menopause and sexual function, as well as for rejuvenating the appearance of the external female genitalia. We reviewed the currently available modalities in this rapidly advancing area of expertise.