Embryonic testicular regression syndrome: a case report.

A case of testicular regression syndrome was reported. The patient was an 18 year old girl presenting with primary amenorrhoea. Physical examination revealed normal female external genitalia and underdeveloped secondary sexual characteristics. Hormonal profile indicated gonadal failure. Chromosome analysis revealed 46,XY karyotype. Diagnostic laparoscopy demonstrated undeveloped internal genital organs. Remnants of epididymis, vas deferens and seminiferous tubule were uncovered during exploratory laparotomy. Ontogeny of sexual differentiation and pathogenesis of testicular regression syndrome were reviewed and discussed.

Primary amenorrhoea: a retrospective study at Siriraj Hospital.

To determine the incidence of etiologic factors responsible for primary amenorrhoea in Siriraj Hospital on the basis of clinical examination and laboratory investigations. A retrospective study was performed from the records of patients who attended the Reproductive endocrine Clinic at Siriraj Hospital from 1 September 1992 to 31 August 1995. During the 3 years of the study period, there were 110 cases of primary amenorrhoea. One hundred and one cases were analyzed: nine cases were excluded because the patients lost follow-up before the final diagnosis could be concluded. The two most common etiologic factors were mullerian agenesis (39.65%) and gonadal dysgenesis (32.69%). Mean age of the patients when they first consulted the physicians was 22.45 +/- 6.06 years. Karyotyping was done on 28 of 32 cases of gonadal dysgenesis; 46,XX karyotype was found in 50 per cent and 45,XO in 14.29 per cent of analyzed cases. Clinical examination gave wrong diagnosis of absent uterus in 4 cases who were in the hypoestrogenic stage with hypoplastic uterus; ultrasonography and laparoscopy gave the wrong diagnosis in 1 case each in our report. These patients successfully menstruated after hormonal replacement therapy. The incidence of etiologic causes and cytogenetic study of primary amenorrhoea in our study is different from earlier reports. Racial and environmental differences may play a role in these differences. The facilities of diagnostic tools may also play a part. However, both clinical examination and many laboratory investigations have to be completed before final diagnosis of etiologic causes of primary amenorrhoea are elucidated. Diagnosis based on inadequate data can be misleading.

Serum cortisol, academic performance and health of siriraj medical students.

A study of serum cortsol in second year medical students at Siriraj Hospital was performed in 1986 curriculum year. Ninety-one volunteers, 28 females and 63 males, participated in this study. Two blood samples were collected from each volunteer, one at the beginning of the second semester and the other at the end of the semester, a few days before the final examination in Physiology. Serum cortisol, which was measured by RIA technique, was used to determine the degree of stress and the ability to adapt to stress. By considering the two cortisol values on second examination, group 2-increased value from first normal value, group 3-decreased value from first high value and group 4-sustained or increased value from first high value. It was found that 57.14 percent of male and 60.71 percent of female students already had higher serum cortisol than normal in the first sample. The academic performance and health were Physiology examination was higher in the group 1+3 than the group 2+4 (p=0.034). Two students, one who was in the group 2 with increased serum cortisol and the other who was in the group 3 with decreased serum cortisol, developed psychological problems in the following year.