Urinary 17-ketosteroids Research Articles

L-Dopa effect on prolactin, follicle-stimulating hormone, and luteinizing hormone in women with advanced breast cancer: A preliminary report

l-Dopa, 250 mg. every 4 hours for 48 hours, followed by 500 mg. every 4 hours for 48 hours, was administered orally to 3 women with advanced cancer who had painful bone metastasis. Serum prolactin, follicle-stimulating hormone, luteinizing hormane, growth hormone, estrone, estradiol, estriol, and progesterone as well as urinary 17-ketosteroids and 17-hydroxysteroids were determined daily. Complete remission of bone pain occurred in 2 patients. Serum prolactin levels fell by 51.2 and 49.2 per cent, respectively, in these 2 patients. No change in bone pain occurred in the third patient; serum prolactin also failed to change in this patient. No other consistent laboratory changes were noted. These data suggest that l-dopa may act through suppression of prolactin to effect clinical remission of breast cancer in some patients.

Carcinoma of the adrenal cortex with hyperaldosteronism.

A 34-year-old woman with hypertension and hypokalemia was found to have a carcinoma of the adrenal cortex. Excretion of urinary corticoids and 17-ketosteroids was normal. Urinary aldosterone excretion was high and was unchanged by sodium loading and plasma renin concentration was low. She has remained well for 6 months following surgery with return of blood pressure and serum potassium to normal.

Steroid, follicle-stimulating hormone, and luteinizing hormone profiles in identical twins with polycystic ovaries

Identical twins (age 16) with polycystic ovarian disease documented by laparoscopy are compared to a “normal” 18-year-old sibling. Fractionation and individual estimation of urinary 17-ketosteroids, 17-ketogenic steroids, pregnanetriol, and total estrogen were performed on both amenorrheic twins and their normal menstruating sibling. Steroid values were obtained during adrenal suppression and after adrenal provocation with adrenocorticotropic hormone nd metyrapone. Serum levels for follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were obtained periodically over a period of 16 months on the twins with polycystic ovarian disease. All 3 siblings gave evidence of androgen overproduction on the part of the ovaries and adrenals. Serum LH values in the twins were elevated but exhibited considerable fluctuation. Serum FSH values were lower but also manifested considerable variation. The similar steroid profile in the 3 siblings and the LH/FSH pattern in the identical twins are discussed.

Hirsutism in Adolescent Girls

Abnormal sexual hair growth may result from excessive production of androgens or factors sensitizing the hair follicle apparatus to normal levels of endogenous androgens. Hirsutism may be encountered in endocrinologic disorders involving adrenals and ovaries, pituitary disorders which stimulate the adrenals or ovaries, and thyroid troubles. The most important laboratory test is the estimation of urinary 17-ketosteroids before and after adrenal suppression.

Effect of growth hormone on urinary 17-ketosteroids in childhood

Studies of the urinary 17-ketosteroids of eight growth hormone-deficient prepubertal children disclosed levels much lower than those of normal subjects of similar age. After 2 yr of growth hormone administration, both C 19O 2 and C 19O 3 androgen metabolites increased substantially in all subjects, but urinary corticoid levels had not increased proportionately. Androsterone levels demonstrated the most significant increase. 17-KS excretion in response to ACTH was increased after growth hormone therapy, although the corticoid response was not proportionately augmented. Growth hormone is proposed as one factor responsible for the increasing androgen secretion that characterizes the maturing childhood adrenal.

The effect of Soldactona (canrenoate-potassium) on plasma testosterone and androstenedione and urinary 17-ketosteroids and 17-hydroxycorticosteroids.

ABSTRACT The aim of the present study was to investigate the effect of the aldosterone antagonist Soldactona® on the plasma concentrations of testosterone and androstenedione and the urinary excretion of 17-ketosteroids and 17-hydroxycorticosteroids. In the control samples, a diurnal variation of plasma testosterone similar to that of plasma cortisol was observed. Soldactona® caused a rapid and -marked fall in plasma testosterone and a decrease in the urinary 17-ketosteroids. No appreciable alterations could be demonstrated in the plasma androstenedione or the urinary 17-hydroxycorticosteroids. It is concluded that Soldactona® causes a decreased secretion of testosterone from the testes.

Ectopic Adrenocorticotropin Syndrome Associated with Carcinoma of the Colon

A 60-year-old man, with metastatic adenocarcinoma of the colon, presented with hypokalemic alkalosis, proximal myopathy, edema, glucose intolerance, and anemia. Elevated concentrations of plasma cortisol and radioimmunoassayable corticotropin (RIA-ACTH) and urinary 17-ketogenic steroids and 17-ketosteroids were not suppressed following the oral administration of dexamethasone, 8 mg per day for 2 days. The concentration of bioassayable ACTH in the colonic tumor was elevated, and a positive arteriovenous difference in radioimmunoassayable ACTH was demonstrated across the primary tumor. These data are interpreted as indicating that the tumor was the source of production and secretion of excessive ACTH and the resulting severe hyperadrenocorticism. The association of the ectopic ACTH syndrome with this nonchromaffin colonic neoplasm is extremely rare.

The Incidence of Associated Anomalies in 105 Patients with Congenital Adrenal Hyperplasia

A survey of 105 patients with defective adrenal steroid 21-hydroxylation, the most common defect in congenital adrenal hyperplasia, has been carried out to determine the presence of additional congenital or developmental anomalies. The following is a report of this survey. The diagnosis of congenital adrenal hyperplasia was suspected in infants who presented with ambiguous genitalia or with defect in electrolyte metabolism manifested by failure to thrive, vomiting and dehydration with hyponatremia and hyperkalemia. Measurement of elevated levels of urinary 17-ketosteroids, 11-keto pregnantriol and pregnantriol confirmed the diagnosis. Seventy-two (68.6%) of the 105 patients surveyed demonstrated defects in electrolyte metabolism and 39 of these were males.

Profiling urinary steroids. A reliable procedure

A relatively simple method of gas chromatography, permiting the quantitative estimation of the most important urinary 17-ketosteroids and 17-OH corticosteroids, is reported. The procedure consists in enzyme hydrolysis, dichloromethane extraction, and (without any further purification) gas-liquid chromatography of the steroids as their o-methyloxime-trimethyl silyi ether (MO-TMS) derivatives. The method is shown to be useful in clinical studies.

Endocrine effects of grouping and dominance rank in squirrel monkeys

Urinary 17-hydroxycorticosteroids (17-OHCS), total catecholamines and 17-ketosteroids (17-KS) were determined for two groups of squirrel monkeys. One group had been colonized for four years and the other group had lived in isolation for three years. Compared to the isolated animals, the colonized monkeys showed elevated 17-OHCS but unchanged catecholamine and 17-KS levels. In the colonized group the dominant animals had the highest 17-OHCS levels and the lowest catecholamine levels, while the subordinate animals showed lower 17-OHCS levels and elevated catecholamine levels. 17-KS levels were related to dominance rank by a J-shaped function. The data are interpreted as showing that high levels of adrenocortical output are necessary for the maintenance of the group of behaviors that result in a high position in the dominance order. It is suggested that the results of this study on primates were contrary to the results of most studies on rodentia because these orders use different behavioral methods to determine dominance relationships.

Photonometric correction in the determination of urinary 17-ketosteroids

Photonometric correction in the determination of urinary 17-ketosteroids

Inhibitory Effect of Vitamin B12on Cortisone and Acth

SummaryCortisone and ACTH treatment of rheumatoid arthritis resulting in subjective and objective improvement of the disease, including normalisation of S.R. and serum iron. etc., is accompanied by a marked increase of the pyruvic acid content of the blood. By chance it was noticed some time ago that vitamin B12 increases the decomposition of pyruvic acid and simultaneously removes the cortisone effect. The observation has been tested in four cases of febris rheumatica. After cortisone or ACTH effect was established in the form of lower temperature and less pain, vitamin B12 was administered in doses of 100—200 μg. i.m. twice daily. In all cases the effect has been uniform, i.e., the temperature has risen sharply and the pain has been intensified. Concurrently, the pathological pyruvic acid levels have been reduced to normal.A case of sclerodactylia treated with electric shocks showed increased excretion of 17-ketosteroids in urine and higher pyruvic acid levels in the blood, all of which indicated increa...

固型試料投入法を用いたガスクロマトグラフイーによる尿中17-KS分画の測定に関する研究

固型試料投入法を用いたガスクロマトグラフイーによる尿中17-KS分画の測定に関する研究

Metastatic Adrenal Cortical Carcinoma: Biochemical Changes Accompanying Clinical Regression During Therapy with o,p'-DDD

Abstract A 7-year-old girl with a six-month history of increasing virilism, growth, and acne excreted supranormal amounts of urinary 17-ketosteroids (87.6 mg/24 h). ACTH stimulation and dexamethasone suppression studies indicated adrenal tumor. A large left adrenal carcinoma was removed. Metastases were not observed. Postoperatively, 24-h urinary ketosteroids remained supranormal (16 mg). Sudden fever, cough, and hemoptysis precipitated hospitalization 42 months later. Bilateral lung metastases, a mass in the right upper quadrant, virilism, advanced bone age, and supranormal 24-h urinary ketosteroids (166 mg) and hydroxysteroids (16 mg) were found. The patient received 240 g of o,p'-dichlorodiphenyl-dichloroethane (o,p'-DDD), whereupon the abdominal mass and lung lesions regressed and 24-h urinary ketosteroids and hydroxysteroids decreased. Since this treatment (which ended April, 1968) the patient has been maintained at home on 7.5 g o,p'-DDD/day and replacement therapy with 9-α-fluorohydrocortisone and cortisone acetate. Almost all signs and symptoms have disappeared and urinary steroids are normal.

Drug interference with measurement of adrenal hormones in urine: analgesics and tranquilizer-sedatives.

Abstract Twenty-four-hour urinary 17-hydroxycorticoids, free 11-hydroxycorticoids, 17-ketosteroids, and catecholamines were measured repetitively in a volunteer subject during control and base-line...

Analysis of total, grouped, and individual urinary 17-ketosteroids: a critical evaluation.

ABSTRACT The complex origin of urinary 17-ketosteroids on the one hand, and the need for technical simplicity on the other, make it desirable to have available a series of analytical methods. In some circumstances it may be sufficient to obtain a simple overall measurement which is highly non-specific; in others it may be desirable to measure, with greater specificity and at the cost of greater complexity, the 11-deoxy and/or the 11-oxy ketosteroid moieties; in still other circumstances it may be important to assess the excretion of the individual ketosteroids with methods of high precision and specificity, but of proportionately greater technical complexity. Various procedures have been investigated, especially with respect to accuracy and specificity. Hydrolysis with perchloric acid in tetrahydrofuran produces the same extensive destruction found with other mineral acids. The Girard reaction greatly improves specificity but does not remove all spurious Zimmermann chromogens. Thin-layer chromatography does not insure complete colorimetric specificity either, and it is found to be a prerequisite for quantitative gas chromatography. GLC using chloromethyldimethyl silyl ethers and 5α-dihydrotestosterone as an internal standard provides excellent separation and quantitation of the 7 individual 17-ketosteroids. Extensive precautions are required with GLC methods (including this one) to find and eliminate contaminants which have the same retention time as steroids of interest; the problem of specificity, so well known with Zimmermann chromogens, is not eliminated by the use of GLC. A method is described for purification and group separation (11-oxy, 11-deoxy) of the 17-ketosteroids; this is followed by colorimetrie measurement of the groups or, after recombining them, by quantitative GLC analysis to measure the individual steroids.

Analysis of urine 17-ketosteroids by column chromatography on silica gel

The method presented here for 17-ketosteroid determination consists in column chromatography on silica gel containing 10% gypsum, with chloroform-ethanol gradient as mobile phase. The urinary 17-ketosteroids extracted with benzene under conditions of acid hydrolysis yielded after separation on the column 12 different components. For colorimetric determination of the 17-ketosteroids, a modification of Zimmermann's method was used. The method of determination was tested on clinical material by determining the content of the individual 17-ketosteroids in the urine of healthy individuals and in pathological urine.

Single dose dexamethasone in treatment of congenital adrenocortical hyperplasia

The observation that dexamethasone given normal individuals as a single dose at midnight results in low levels of plasma cortisol at 8:00 a.m., presumably by inhibiting the early-morning pituitary discharge of ACTH, stimulated investigation of the therapeutic value of dexamethasone so administered to patients with congenital adrenocortical hyperplasia. Detailed studies on four patients are presented. Results of short-and long-term treatment suggest that single, appropriately timed doses of 0.25 to 0.75 mg daily cause normalization of urinary 17-ketosteroid and pregnanetriol output, provide sufficient daily glucocorticoid for bodily needs, and simplify therapy for this disorder in adults and adolescents who have reached their mature height.

The pattern of urinary excretion of individual 17-ketosteroids in rhesus monkeys.

ABSTRACT A systematic procedure for the extraction, separation, purification and colorimetric determination of urinary individual 17-ketosteroids in normal rhesus monkeys is described. Dehydroepiandrosterone was extracted after hot hydrolysis of the urine at neutral pH and the remaining steroid conjugates were extracted at pH 2 by the addition of ammonium sulphate. The liberated steroids were extracted after enzyme hydrolysis and the ketonic steroids were separated from the non-ketones by the Girard T reaction. The 11-deoxy steroids were separated from the 11-oxygenated steroids on a Celite column. They were further separated by paper chromatography and after elution, the individual 17-ketosteroids were estimated by the Zimmermann reaction. Normal mean excretion values in 30 female monkeys for total neutral 17-ketosteroids were 1.8 mg/24 h (range 1.5–2.6); total 17-hydroxycorticosteroids, 3.1 mg/24 h (range 2.2–4.8); androsterone, 38.6 μg/kg/24 h (range 9.3–60.2); aetiocholanolone, 19.2 μg/kg/24 h (range 6.8–30.7); dehydroepiandrosterone, 30.8 μg/kg/24 h (range 13.4–50.6); 11-ketoandrosterone, 7.5 μg/kg/24 h (range 5.1–14.1); 11-ketoaetiocholanolone, 10.2 μg/kg/24 h (range 6.8–18.3); 11β-hydroxyandrosterone, 15.4 μg/kg/24 h (range 8.8–26.7); 11β-hydroxyaetiocholanolone, 19.6 μg/kg/24 h (range 12.2–33.1). For total neutral 17-ketosteroids in 20 males, they were 2.5 mg/day (range 2.3–4.1); total 17-hydroxycorticosteroids, 3.7 mg/day (range 2.8–5.3); androsterone, 51.5 μg/kg/24 h (range 12.3–76.7); aetiocholanolone, 22.6 μg/kg/24 h (range 8.7–42.3); dehydroepiandrosterone, 41.3 μg/kg/24 h (range 16.9–59.7); 11-ketoandrosterone, 9.6 μg/kg/24 h (range 6.4–16.3); 11-ketoaetiocholanolone, 12.3 μg/kg/24 h (range 8.2–20.5); 11β-hydroxyandrosterone, 17.5 μg/kg/24 h (range 11.7–29.2); 11β-hydroxyaetiocholanolone, 21.7 μg/kg/24 h (range 14.5–36.4).

Fimilial primary aldosteronism with delayed glucocorticoid responsiveness: A new sndrome

Two brothers, ages 7 and 9, with systolic and diastolic hypertension; normal growth; absence of virilism; hypokalemic alkalosis; elevated urinary aldosterone (UA), tetrahydroaldosterone (THA), tetrahydrocorticosterone; low plasma renin activity (PRA); and high plasma aldosterone (PA) were studied. Mild elevation of urinary 17-ketosteroids (KS) and marked elevation of 17-ketogenic steroids (KGS) was noted intermittently in both boys. Plasma cortisol (F) was low-normal in the older and normal in the younger subject. Spironolactone in the younger corrected the hypokalemic alkalosis without lowering the BP. Dexamethasone therapy, 8 mg/day for one week, also corrected the hypokalemia and lowered the BP withing the first week in bothe subjects; correction has been sustained for four months with prednisone, 5mg/day in the older and 2.5 mg/day in the younger subject. THA remainder elevated but PRA became normal during the first 2 weeks of treatment. THA and UA fell to normal levels and F was suppressed by the fourth week, but KS adn KGS remained intermittently elevated. The unique features in these cases are: a.) occurrence in male siblings; b.) lack of biochemical data supporting a complete or partial 11, 17, or 21-hydroxylase deficiency; c.) rapid fall in BP elevation and rapid correction of PRA and PA abnormalities with large doses of glucocorticoids; d.) delayed fall of THA excretion and e.) persistent elevation of KGS and KS. The findings of a generalized adrenocortical hyperactivity not totaly suppressed by glucocorticoid therapy are consistent with adrenocortial adenomata.