Urinary 17-KS Excretion Research Articles

Androgen biosynthesis by ovarian lipoid cell tumor.

A lipoid cell tumor of the ovaries, producing masculinization in a 27-yr-old female, was shown to produce the following steroids in vitro: testosterone, androstenedione and 17α-hydroxyprogesterone. The biosynthesis of testosterone, a very potent androgen, may help to explain the marked masculinization accompanied by normal urinary excretion of 17-KS. It is proposed that the results of similar studies should clarify the classification of ovarian tumors, especially in regard to their steroid synthetic potential and possible cell source of the enzymes responsible for such synthesis.

An endocrine mechanism involved in testicular changes produced by a dl-ethionine supplemented diet: a study of morphologic changes and endocrine dysfunction.

The endocrine-morphological relationship in testicular lesions of rats treated with ethionine and testosterone was investigated. This was done through indirect evaluation of the androgenic activity by the estimation of urinary 17-KS excretion. It has been found that small and large doses of testosterone (12 clays of treatment) prevent histologic testicular changes clue to ethionine. However small doses of testosterone given over a longer period (24 days) did not prevent ethionine-induced testicular histologic changes. Large doses of testosterone did not prevent damage to spermatogenesis during continuous ethionine administration, but did prevent Leydig cell hyperplasia. Ethionine alone stopped spermatogenesis, and induced Leydig cell hyperplasia. Leydig cell hyperplasia therefore may have been compensatory. Ethionine treatment decreased the excretion of 17-KS prior to the appearance of any testicular morphological changes. Therefore ethionine presumably affected the androgenic activity directly if 17-KS excretion may be used as an index of androgenic activity. Intraperitoneal (I.P.) administration of ethionine diminished the 17-KS excretion by two thirds. Since I.P. ethionine diminished in 12 days the excretion of 17-KS in the absence of histologic testicular changes and was followed by an increase in the excretion of 17-KS associated with Leydig cell hyperplasia after 24 days, this would suggest that functional changes precede histologic changes. Morphological liver changes were demonstrable within 24 days after initiating oral ethionine therapy but not after I.P. ethionine. Gastrointestinal versus systemic absorption of the administered ethionine may be a factor. Finally, it may be concluded that an endocrine-morphological relationship exists in the pathogenetic effect of ethionine on testicular changes observed in albino rats.

A comparison of plasma 17-hydroxycorticosteroid levels with the urinary excretion of 17-ketogenic steroids and 17-ketosteroids.

ABSTRACT Plasma 17-OHCS and urinary excretion of 17-KGS and 17-KS have been compared in 24 patients with chronic polyarthritis, who had been treated for years with corticosteroids. All medication was discontinued 3 days before this investigation. To test the adrenal cortical response the patients were given intramuscular injections of 40 IU of a long-acting ACTH preparation twice daily on 6 consecutive days. Plasma 17-OHCS were determined at 8 a. m. before the first ACTH injection and 3 hours after the injection on the first and sixth treatment days. The urinary concentration of 17-KGS and 17-KS were measured in 24 hour samples on the control day, and on the first and sixth days of treatment. The results show a greater variation in the 17-KS groups than in the 17-KGS and 17-OHCS groups, the smallest variation being in the 17-OHCS groups. There is a significant increase in all values after the first ACTH injection and a further significant increase after the sixth injection, but the t-values are much larger in the 17-OHCS groups than in the 17-KS groups, while the 17-KGS groups occupy an intermediate position. The plasma 17-OHCS values correlate better with the urinary 17-KGS than with the 17-KS. The correlation between 17-OHCS and 17-KGS is not very good (P > 0.05). There is a negative correlation between 17-OHCS and 17-KS control values, and the correlation after ACTH is very poor. 17-KGS correlate well with 17-KS (P < 0.01).

The effects of chorionic gonadotropin in Klinefelter's syndrome.

The effects of large doses of human chorionic gonadotropin administered for long periods of time were studied in a case of Klinefelter's syndrome exhibiting the Barr nuclear chromatin body as in the female. There was an evident relationship between the histologic changes in the testes (Leydig cell hyperplasia and signs of active secretion) and the increase in the urinary excretion of 17-KS and estrogens. The mammary tissue showed an increase in the number of ducts with papillary projections lined by multilayered hyperplastic epithelium. Urinary gonadotropin excretion remained unchanged.

ADRENAL FUNCTION IN ALLERGY

An evaluation of a schedule of intermittent prednisolone therapy in the treatment of 42 children with severe allergic disorders, who had failed to respond to ordinary allergic management, is presented. In 11 subjects the response was excellent; in 28, good; and in 3, poor. No serious complications were observed as a consequence of the method of treatment. Appraisal of adrenal function, as measured by a standardized test of response to adrenocorticotropin, was undertaken before and after the institution of therapy in the majority of the subjects. The mean urinary excretion of 17-hydroxycorticosteroids in the test observed after the introduction of therapy was significantly less than that prior to treatment. This suggests that the regimen of therapy employed impairs the adrenals' response to exogenous ACTH. The unresponsiveness of the adrenals was at least partly dependent upon the dosage of hormone administered. The effect of intermittent steroid therapy on the urinary excretion of adrenocortical steroids in 16 subjects is also reported. Some hypofunction of the adrenals, which is overcome only partially during the days hormones are withheld, is suggested by the data on 17-OHCS. There was no discernible effect on the urinary excretion of 17-KS. The indications for use of steroid therapy in allergic children and the implications of the findings in this study are discussed. Although a schedule of intermittent steroid therapy was found to be useful as an adjunct in the treatment of intractable asthma and atopic dermatitis, it should not be used as a substitute for conventional methods of treating allergic patients. The criteria for selection of patients and the precautions required in the administration of continuous hormone therapy, should also be applied in the use of intermittent hormone therapy.

Effects of semistarvation and water deprivation on adrenal cortical function and corticosteroid metabolism.

The urinary excretion of 17-KS and 17-OH-CS and the level of circulating unconjugated 17-OH-CS in the plasma were determined in 12 healthy young subjects during a 16-day period of acute undernutrition. In half the group, the intake of water was also significantly restricted during the first 5 1/2 days. The data indicate that although the urinary excretion of steroid metabolites decreased rapidly during the first 6 days of undernutrition and then stabilized at a level approximately half that seen in the control period, the level of circulating unconjugated 17-OH-CS in the plasma was not depressed by this degree of acute undernutrition and protein deprivation. Dehydration increased the level of circulating unconjugated 17-OH-CS, indicating that the pituitary-adrenal axis could respond to ‘stress’ when the diet was calorically inadequate and protein-deficient. These findings have been interpreted as indicating that acute undernutrition and protein deprivation alter the catabolism of adrenal steroids, but that the level of circulating hormonally-active corticosteroids reaching the tissues of the organism is probably adequate. Submitted on July 28, 1958

高血圧症と副腎皮質機能 (第1報) : 緒論並びに副腎皮質機能測定法及び臨床高血圧症に於ける副腎皮質機能の研究

There are three types of experimental hypertension : pressoreceptor denerved hypertension (Hering, 1927), renal hypertension (Goldblatt, 1934; Page, 1939), and DCA hypertension (Selye, 1943). In these hypertensions, much has been done for the research of cause of hypertension, but each of them can not explain the whole phenomenons of hypertension. Therefore, it is necessary to see the correlation to each other. Selye produced malignant hypertension as well as nephrosclerosis, acute nephritis, and albuminuria in animals by means of long-term administration of DCA. He attributed them to be due to an excess response of pituitary-adrenal system, which was called general adaptation syndrome. However, the relationship between hypertension and pituitary-adrenal system is not so clear that the influence of adrenal cortex on hypertension seemes to be questionable. The auther investigated the function of adrenal cortex by measuring 17-KS excretion in urine in hypertensive patients of various types, Goldblatt's and Page's renal hypertensive dogs, DCA-hypertensive rats, salt hypertensive rats, and also pressoreceptor denerved hypertensive dogs.Method of measurement of urinary 17-KS excretion The auther adopted Miyake's method where Drekter's extraction, Pearson's color reaction and Fraser's equation were applied on the basis of Zimmermann's color reaction.The 1st Experiment : The adrenocortical function in hypertensive patient.The auther performed measurement of 17-KS excretion in urine, of circulating eosinophils count, and 4-hour epinephrine test in hypertensive patients of various types, (one Cushing's syndrome, one acromegaly, 26 essential hypertension, 18 renal hypertension, and one pheochromocytoma) to see adrenocortical function.Results 1) 17-KS excretion in urine Essential hypertension : In 7 of 16 males it showed low values and in 9 normal values. In 6 of 10 females low values and in 4 normal.Renal hypertension : In 9 of 10 males it revealed low values and one normal value.Acromegaly : One male, normal value.Pheochromocytoma : One male, normal value.Cushing's syndrome : One female, high value. This was just one case which showed a high level of urinary 17-KS excretion.2) Circulating eosinophils count Essential hypertension : In 9 of 26 patients, it showed insufficiency.Renal hypertension : In 5 of 12 patients, it showed insufficiency.3) 4-hour epinephrine test Essential hypertension : In 11 of 14 patients, it showed insufficiency.Renal hypertension : In 5 of 6 patients, it showed insufficiency.Acromegaly : In one patient, it showed insufficiency.

Qualitative differences in urinary 17-ketosteroid excretion in patients with Cushing's syndrome.

Forbes & Albright (1951) studied the values of urinary 17-ketosteroids (17-KS) in relation to the anatomical finding of the adrenal glands in patients with Cushing’s syndrome and found that patients with benign tumour of the adrenal cortex have a low excretion of 17-KS, those with adrenal cortical hyperplasia a moderately increased excretion of 17-KS, whilst patients with malignant tumour of the adrenal cortex have a markedly increased excretion of 17-KS. According to their interpretation, the adrenal cortical adenoma produces large amounts of glucocorticoids, which inhibit the elaboration of corticotrophin (ACTH), and this in turn causes atrophy of the adrenal glands. Thus a decrease in urinary 17-KS excretion is the logical consequence of such hypophyseoadrenal relationships. Subjects suffering from adrenal cortical hyperplasia do, however, produce increased quantities both of androgens and glucocorticoids, probably due to the high secretion of corticotrophin.

急性膵炎時尿中17-KS量の変動に関する研究 第1編 急性膵炎時尿中17-KS量の変動

急性膵炎時尿中17-KS量の変動に関する研究 第1編 急性膵炎時尿中17-KS量の変動

急性膵炎時尿中17-KS量の変動に関する研究 第2編 急性膵炎時各種薬物投与の尿中17-KS排泄量の変動に及ぼす影響

急性膵炎時尿中17-KS量の変動に関する研究 第2編 急性膵炎時各種薬物投与の尿中17-KS排泄量の変動に及ぼす影響

FURTHER STUDIES ON THE TREATMENT OF CONGENITAL ADRENAL HYPERPLASIA WITH CORTISONE

Three cases of congenital adrenal hyperplasia with disturbed electrolyte metabolism, followed for 14 to 20 months, have been reported in detail. The effects of cortisone (compound E) and corticosterone (compound B) on the suppression of the abnormal adrenals and on the electrolyte disturbance have been discussed. Cortisone produces more marked suppression of the adrenal overactivity/mg. (as measured by the urinary excretion of 17-KS), but less sodium retention than corticosterone. Both steroids, however, significantly improve the electrolyte abnormality. The possible mechanism of action of cortisone on the electrolyte metabolism is discussed. Suggestions concerning the therapeutic management of these patients are offered. The use of adequate NaCl without DCA in the initial treatment is emphasized, since suppression of the adrenal with cortisone seems to alter materially DCA requirement. The final combination of therapy, however, must be decided in each patient individually.

17-Ketosteroid Excretion in Liver Disease

Summary The 24-hour urinary 17-KS excretion was determined in 6 normal adults and 21 patients jaundiced from hepato-cellular disease or extra-hepatic obstruction. These results were compared with a number of standard liver function tests to evaluate this procedure as a method of differentiating hepatocellular from extra-hepatic obstructive jaundice. Our results indicate a decrease in the urinary 17-KS in both types of jaundice. No correlation with standard liver function tests could be found.