泌尿器科領域に於ける尿中17-KS分劃の研究

Abstract

Although many works have been made on the urinary 17-KS determinations as one of the studies concerning with the androgen metabolism in male hypogonadism, the majority of them have dealt with the urinary total 17-KS determinations alone, which were not enough to know the trend of the intricate androgen metabolismUnexpectedly few workers have reported about the urinary 17-KS fractions in patients of male hypogonadism. There is scarecely any report on the details of the pattern of urinary 17-KS fractions in male hypogonadism classified according to the type of the disease.From this point of view, Dr. Kawakura in our department has previously reported on the basal pattern of the fractionations in the various types of male hypogonadism (Jap. J. Urol., 55, 950, 1954).The present writer has studied on the shift of urinary 17-KS fractions following the administration of ACTH and HCG as an aid to know the pituitary-adreno-gonadal relationship.The findings are summarized as follows;1. Shift of urinary 17-OHCS output following administration of ACTH has shown retardation type of response; i. e., the rate of increase of urinary 17-OHCS was retarded in all 4 cases of hypo-GTE, in one case out of 2 hyper-GTE and in one anorchia, compared to the young healthy.2. The increase of urinary total 17-KS has been gradual and slight after ACTH administration in the patients of male hypogonadism, compared to the young healthy.3. As regards urinary levels of each 17-KS fractions, their responses to ACTH were lower in the hypo-GTE than in the normal young. In other types of male hypogonadism, some case responded as well as the normal young, others have responded more slightly than the normal young.4. Andro.+Etio. /DEA.+11-oxy-17-KS ratio after ACTH administration has definitely decreased in the normal young, but slightly decreased in the castrated and male hypogonadism, and this ratio has even increased in a few cases of Klinefelter's syndrome and hypo-GTE.5. Total urinary 17-KS output after HCG administration has increased in only 2 of 4 hypo GTE and one of 3 Klinefelter's syndrome. Except these cases, total 17-KS has scarcely shown any responses to the HCG administration.6. Increase of Andro. and Etio. fractions after HCG administration has been small in every type of male hypogonadism.7. Andro.+Etio./DEA.+11-oxy-17-KS ratio after HCG administration has been higher than 2.0 in the normal young, but lower than 2.0 in all cases of castrate and male hypogonadism. Andro.+Etio./11-oxy 17-KS ratio following HCG administration has been above 2.0 in the normal young, but lower than 2.0 in the male hydrogonadism except one hypo-GTE (after medical treatment) and one hyper-GTE.8. The ratio of Andro./Etio. has not shown any apparent changes after the administration of ACTH and HCG.Reviewing the above mentioned data, the writer has made a brief comment on the androgen metabolism which would take place at the gonad and adrenal cortex.