泌尿器科領域における Androgen 代謝の研究

Abstract

24 hour urine values of testosterone glucuronide were determined using the modified Vermeulen-Verplancke's method (1963).A. Healthy male, healthy female, male castrate and male hypogonadism.1. Baseline value of urinary T. was 49.0±20.5γ/day in 15 healthy young males, 26γ/day in a 64 years old healthy male, and 16.0±8.9γ/day in 4 healthy young females.The value was 15.3±3.7γ/day in 7 adult male castrates and 17.1±6.0γ/day in 8 male hypogonadisms.2. Following HCG administration (5000U×2 day for three days), the excretion of urinary T. showed a remarkable increase (113%) in healthy young male, but only a slight increase (53%) in an aged man.In 7 cases of male castrates and 8 cases of Klinefelter's syndrome, T. excretion value was not influenced by HCG administration.3. The increase of urinary T. following ACTH administration (ACTH-Z 40U) was variable (50-200%) in a healthy young male.Urinary T. value in 3 cases of Klinefelter's syndrome was not influenced by ACTH administration.Urinary T. of 7 cases of male castrates increased following ACTH administration, and it was noted that, the rate of increase was apparently dependent upon the lapse of time after castration.The castrated 4-20 years ago showed only a slight increase (51%), while the recently castrated showed a remarkable increase (151%).4. The excretion of urinary T. on the day of testosterone administration (T. propionate in oil 100mg) was as a rule over 100γ/day in healthy males, but definitely lower in male castrates (43.0γ/day) and male hypogonadisms (51.1γ/day).B. Cushing's syndrome.Male patients of Cushing's syndrome (3 cases with bilateral adrenal hyperplasia) showed normal urinary T. value before and after the operation.However, female patients (1 case with unilateral adrenal adenoma and 1 case with bilateral adrenal hyperplasis) showed increased urinary T. excretion value (80 and 28γ/day) before the operation, and the value decreased to normal female range after the operation.In 2 cases after bilateral adrenalectomy (1 male and 1 female), urinary To value did not show any significant change following ACTH or HCG administration.C. Intersex.Urinary T. value in one case of male hermaphroditism (16 years old) and in one case of female hermaphroditism due to congenital adrenogenital syndrome (20 years old) was in the normal range of a healthy young male.Urinary T. in one case of testicular feminization (16 years old) whose testicles had been removed 7 years ago, was 26γ/day, and HCG administration had no increasing effect, but the value following ACTH administration reached up to 103γ/day.