1.Mixed gonadal dysgenesis with an ovarian germ cell tumor in a Filipino adolescent.
Marie Julianne C. RACOMA ; Julianne Keane M. PASCUAL ; Edsel Allan G. SALONGA ; Mary Ann R. ABACAN
Acta Medica Philippina 2022;56(3):143-148
We present a case of a 13-year-old Filipino patient with ambiguous genitalia, randomly assigned as female at birth and was subsequently reared as such. Starting at 10 years of age, secondary male sexual characteristics emerged. However, medical consultation was sought only when the patient developed a gradually enlarging and painful abdominal mass. After cytogenetic studies, we are able to identify the case as Disorder of Sex Development, 45,X/46,X,der(Y) mosaicism, mixed gonadal dysgenesis. Further imaging, laparotomy and histopathology, revealed that the abdomino-pelvic mass was from the right ovary, composed of immature teratoma. Ductus deferens and epididymis were also identified within the right ovary. At the time of presentation, the patient was already experiencing gender dysphoria. This report not only highlights the wide spectrum of phenotypes in mixed gonadal dysgenesis, but also stresses the importance of proper gender assignment during the newborn period in patients with disorders of sex development.
Key Words: disorder of sexual development, ambiguous genitalia, mixed gonadal dysgenesis, mosaicism, 45,X/46,X,der(Y) karyotype, immature teratoma, gender dysphoria
2.Interim In vitro Dose-Response Curve for the Dicentric Biodosimeter Assay from a Philippine Radiotherapy Facility using a Linear Accelerator
Antonio Carlo D. De Guzman ; Carmencita D. Padilla ; Henri Cartier S. Co ; Elrick T. Inocencio ; Edsel Allan G. Salonga
Acta Medica Philippina 2021;55(1):117-125
		                        		
		                        			
		                        			Background. Accidental radiation exposure can occur anytime. Biodosimeters help in quantifying the absorbed dose of individuals who are not equipped with personal dosimeters during radiation exposure. The dicentric assay can quantify radiation damage by correlating radiation dose exposure with the frequency of dicentric chromosomes in the peripheral lymphocytes extracted from exposed individuals.
Objective. The study aims to present the interim results of the reference dose-response curve for a Philippine radiotherapy facility constructed using a 6MV linear accelerator (ClinacX, Varian).
Methods. Samples of peripheral blood from healthy volunteers were irradiated in a customized water phantom of doses 0.10 to 5.0 Gray using a linear accelerator. The irradiated samples were cultured and analyzed following the International Atomic Energy Agency Cytogenetic Dosimetry Protocol (2011) with modifications. Linear-quadratic model curve fitting and further statistical analysis were done using CABAS (Chromosome Aberration Calculation Software Version 2.0) and Dose Estimate (Version 5.2). Interim results of the samples were used to generate these curves.
Results. The dose-response curve generated from the preliminary results were comparable to published dose response curves from international cytogenetic laboratories.
Conclusion. The generated dose-response calibration curve will be useful for medical triage of the public and radiologic staff accidentally exposed to radiation during medical procedures or in the event of nuclear accidents.
		                        		
		                        		
		                        		
		                        			 Cytogenetics
		                        			;
		                        		
		                        			  Biological Assay
		                        			;
		                        		
		                        			  Chromosome Disorders
		                        			;
		                        		
		                        			  Cytogenetic Analysis
		                        			;
		                        		
		                        			  Radiation
		                        			
		                        		
		                        	
3.Tetrasomy 9p syndrome in a Filipino infant
Ebner Bon G. Maceda ; Erena S. Kasahara ; Edsel Allan G. Salonga ; Myrian R. Dela Cruz ; Leniza De Castro-Hamoy
Acta Medica Philippina 2020;54(4):431-434
		                        		
		                        			
		                        			Tetrasomy  9p  syndrome  is  a  rare  chromosomal  abnormality  syndrome  whose  most  common  features  include  hypertelorism,  malformed  ears,  bulbous  nose  and  microretrognathia.  These  features  present  as  a  result  of  an  additional  two  copies  of  the  short  arm  of  chromosome  9.  Here we  present  a  neonate with  characteristic  facial features of hypertelorism, downslanted palpebral fissure, bulbous nose, small cupped ears, cleft lip and palate, and downturned  corners  of  the  mouth.  Clinical  features were  consistent with  the  cytogenetic  analysis  of  tetrasomy 9p.  In  general,  clinicians  are  not  as  familiar  with  the  features  of  tetrasomy  9p  syndrome  as  that  of  more  common  chromosomal abnormalities like trisomies 13, 18, and 21. Hence, this case re-emphasizes the importance of doing the standard karyotyping for patients presenting with multiple congenital anomalies. Also, this is the first reported case of Tetrasomy 9p syndrome in Filipinos.
		                        		
		                        		
		                        		
		                        			Isochromosomes
		                        			;
		                        		
		                        			 Hypertelorism 
		                        			
		                        		
		                        	
4.Chromosomal structural abnormalities among Filipino couples with recurrent pregnancy losses
Cutiongco-Dela Paz Eva Maria ; Dion-Berboso April Grace ; Salonga Edsel Allan G. ; David-Padilla Carmencita
Acta Medica Philippina 2011;45(4):58-62
		                        		
		                        			
		                        			Introduction. Recurrent pregnancy loss is a devastating reproductive problem that affects 5% of couples trying to conceive. Majority of the cases are due to cytogenetic errors. This study determines the prevalence of chromosomal structural abnormalities in Filipino couples who presented with 2 or more pregnancy losses.
Methods. Results from chromosomal analysis of couples referred for 2 or more miscarriages done at the Institute of Human Genetics-National Institutes of Health-University of the Philippines, Manila on peripheral blood samples from 1991 to 2010 were restrospectively reviewed.
 
Results. There were 356 couples with a history of 2 or more miscarriages sent for chromosomal analysis from 1991-2010 included in this study. Among these 356 couples, 17 couples (4.8%) were found to be carriers of different chromosomal abnormalies. From a total of 18 cases, there were 13(3.6%) translocations, 1(0.3%) insertion, 2(0.6%) with marker chromosomes, 1(0.3%) pericentric inversion and 1(0.3%) deletion.
 
Conclusion. The overall frequency of chromosomal structural abnormalities among patients with RPL in this study is 4.8% with translocations being the most common type detected. The results of this study are similar to that of previous large-scale studies which have demostrated that parental chromosomal abnormalities are associated with RPL.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			 Female
		                        			;
		                        		
		                        			 RECURRENCE
		                        			;
		                        		
		                        			 PREGNANCY
		                        			;
		                        		
		                        			 CHROMOSOME ABERRATIONS
		                        			;
		                        		
		                        			 ABORTION, SPONTANEOUS
		                        			;
		                        		
		                        			 FEMALE UROGENITAL DISEASES AND PREGNANCY COMPLICATIONS				
		                        			;
		                        		
		                        			 PREGNANCY COMPLICATIONS 
		                        			;
		                        		
		                        			 
		                        			
		                        		
		                        	
            

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