Sample records for 17-ketosteroids

  1. 21 CFR 862.1430 - 17-Ketosteroids test system. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false 17-Ketosteroids test system. 862.1430 Section 862.1430 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  2. Skin surface lipid composition, acne, pubertal development, and urinary excretion of testosterone and 17-ketosteroids in children. (United States)

    Pochi, P E; Strauss, J S; Downing, D T


    Fifty-two children, age 5-10, from acne-prone families, were studied for a period of 1 year to examine the interrelationship between sebum, acne, pubertal development, and urinary steroid excretion. In each of the subjects, 30 boys and 22 girls, the composition of forehead skin lipid was determined 4 times yearly by thin-layer chromatography, with measurement of triglycerides, diglycerides, free fatty acids, wax esters, squalene, cholesterol, and cholesterol esters. Twice yearly, examination was made of the presence or absence of acne, pubertal maturation and the 24-hour urinary excretion of testosterone as determined by radioimmunnoassay, and of total 17-ketosteroids, dehydroepiandrosterone, androsterone, and etiocholanolone, as determined by paper chromatography. The relative amount of sebaceous lipids was positively correlated with age of the subjects (wax esters p less than .001, squalene p less than .05), as was the triglyceride-diglyceride component (p less than .05). No significant correlation was seen with the fatty acids. Acne, primarily comedonal, occurred in 27/52 subjects (15 girls, 12 boys) and was associated with higher sebum values. One-half of the children with acne had no signs of pubertal development. A significantly positive correlation was observed between the relative amount of sebaceous lipid and the urinary excretion of 17-ketosteroids, androsterone, and etiocholanolone in both sexes, and of testosterone and dehydroepiandrosterone in boys. The development of acne in children is an early pubertal event, often evident before other signs of pubertal maturation, and it is associated with an increase in sebum and in the urinary excretion of androgenic steroids.

  3. Anthropometry: Basic Studies ad Applications. Volume 1. 1964-1975 (United States)


    a deteminination of the functional acn reach boundaries for the Australian sale and female pilot populations has been made and certain structural...fields and factor analyzed. Areas covered included physical fitness tests, urinary 17-ketosteroid and androgen output and stress tolerance

  4. Present Concepts in Internal Medicine. Volume 13, Number 1. Endocrinology Research Symposium, (United States)


    have caused overt hyperthyroidism , 14 most have been reported in hypothyroid patients. 15 Presumably long-standing primary hypothyroidism results in...experience (in the absence of conditions causing false positive responses) the presence of elevated urine free cortisol (> 100 Vg/24 h) and lack of...corticoids with normal or subnormal levels of urine 17- ketosteroids. Since adrenal tumors causing Cushing’s syndrome are usually greater than 2 cm in

  5. Excreção urinária de 17-Cetoesteroides neutros no cavalo normal e no cavalo castrado

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    Fernando Ubatuba


    Full Text Available Total urinary neutral 17-steroids were determined in normal and in castrated horses. One liter of a 15-26 hours urine collection was hydrolysed by refluxing with 10% HC1 (v/v for ten minutes and extracted with peroxyde-free ethyl ether. The extract was purified by washing with saturated NaHCO³ and KOH solutions. One half of the crude neutral fraction was fractionated with Girard's "T" reagent . The Zimmermann reaction was performed both in the ketonic and in the crude neutral extracts, using alcoholic 2.5N KOH and a 60 minutes period for the colour development in the dark. Optical density measuments were made in a grating Coleman Universal Spectrophotometer at 420 mµ and 520mµ; for the crude neutral fraction a colour correction equation was applied. The aliquot fraction used for colorimety was adjusted for keeping optical density measurements within the range 0.2 to 0.7. Androsterone (mp. 184-184.5°C with an absorption maximum at 290.5 mµ (Beckman Model DU Spectrophotometer was used as a reference standard. Table I, ilustrates the results obtained. At the 0.05 probability level there is a significant difference among castrated and normal group means (Fischer's "t" test. when were used the data obtained from the ketonic fractions; in spite of the use of a colour correction applied for inespecific chromogens, the same results could not be obtained with the crude neutral fractions, Since Girard's reagent fractionation is generaly accepted as the best method for correcting the inespecific chromogen interference in the determination of the 17-ketosteroids by the Zimmermann reaction, we emphasize the value of the results obtained with the ketonic fractions. From these results it appears, as occurs in others mammals, that castrated horses show a lower level of urinary 17-ketosteroids excretion than the normal horses. The significance of the horse testis contribution for the neutral urinary steroid metabolites is discussed. Since horse urine has a

  6. Informative value of some endocrine homeostatic parameters in the formation of endometrial cancer risk groups

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    Yu. S. Sidorenko


    Full Text Available Twenty-five patients with atypical endometrial hyperplasia (AEH and 90 patients with Stages I-II endometrial cancer (EC were followed up. The patients’ mean age was 44.3±2.1 years. A control group consisted of 20 healthy women matched for age. Before treatment, the authors determined the blood levels of adrenocorticotropic hormone and cortisol by radiometric assay and the content of daily excreted cortisol, cortisone, tetrahydrocortisol, tetrahydrocortisone, 11-hydroxy-17-ketosteroids, estrone, estradiol, and pregnanediol by the conventional classical studies.The nature of the impaired synthesis and metabolism of sex and adrenocorticoid hormones and their degree have been found to coincide, which suggest that it is expedient to use these findings to form EC risk groups in patients with AEH in the late reproductive period.

  7. Cyproterone acetate in the treatment of acne vulgaris in adult females. (United States)

    Hansted, B; Reymann, F


    22 adult females with therapy-resistant acne vulgaris were treated for 12 months with Diane, a drug containing cyproterone acetate and ethinylestradiol. Treatment was withdrawn in 7 patients because of side-effects of lack of of effect. In the remaining 15 patients, the treatment had extremely promising results, from 70 to 90% improvement of the acne. In a remarkably high number of patients, the androgen production, measured by the urinary excretion of fractional 17-ketosteroids, was elevated. None of these patients had signs of endocrinological diseases, in particular no cases of hirsutism of Stein-Leventhal syndrome were found. The current concept of the course of acne is that the conversion in the skin of testosterone to dehydrotestosterone is increased. The finding of an elevated urinary excretion of androgenic substances in this group of acne patients indicates that the pathogenesis is far more complicated.

  8. Sperm count suppression without endocrine dysfunction in lead-exposed men

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    Assennato, G.; Paci, C.; Baser, M.E.; Molinini, R.; Candela, R.G.; Altamura, B.M.; Giorgino, R.

    To determine if increased lead absorption was associated with sperm count suppression or perterbation of the hypothalamopituitary system, the authors compared battery workers (N = 18), who were exposed to high airborne lead levels, with cement workers (N = 18), who were exposed to ambient lead levels. Blood lead, urinary lead, semen lead, and zinc protoporphyrin concentrations were markedly elevated (p < .001) in battery workers. Battery workers had a significantly shifted (p < .025) frequency distribution of sperm count (median count, 45 vs. 73 x 10/sup 6/ cells/cc, respectively). There were no significant differences between the two groups in mean follicle-stimulating hormone, testosterone, prolactin, luteinizing hormone, or total neutral 17-ketosteroid levels. Potential confounding factors (alcohol, cigarette, and coffee consumption, frequency of intercourse, and days of abstinence prior to semen donation) were not significantly different between the two groups. These results suggest a direct toxic effect of increased lead absorption on sperm production or transport in man.

  9. The important roles of steroid sulfatase and sulfotransferases in gynecological diseases

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    Tea eLanisnik Rizner


    Full Text Available Gynecological diseases such as endometriosis, adenomyosis and uterine fibroids, and gynecological cancers including endometrial cancer and ovarian cancer, affect a large proportion of women. These diseases are estrogen dependent, and their progression often depends on local estrogen formation. In peripheral tissues, estrogens can be formed from the inactive precursors dehydroepiandrosterone sulfate and estrone sulfate. Sulfatase and sulfotransferases have pivotal roles in these processes, where sulfatase hydrolyzes estrone sulfate to estrone, and dehydroepiandrosterone sulfate to dehydroepiandrosterone, and sulfotransferases catalyze the reverse reactions. Further activation of estrone to the most potent estrogen, estradiol, is catalyzed by 17-ketosteroid reductases, while estradiol can be formed from dehydroepiandrosterone by the sequential actions of 3-hydroxysteroid dehydrogenase-4-isomerase, aromatase, and 17-ketosteroid reductase. This review introduces the sulfatase and sulfotransferase enzymes, in terms of their structures and reaction mechanisms, and the regulation and different transcripts of their genes, together with the importance of their currently known single nucleotide polymorphisms. Data on expression of sulfatase and sulfotransferases in gynecological diseases are also reviewed. There are often unchanged mRNA and protein levels in diseased tissue, with higher sulfatase activities in cancerous endometrium, ovarian cancer cell lines, and adenomyosis. This can be indicative of a disturbed balance between the sulfatase and sulfotransferases enzymes, defining the potential for sulfatase as a drug target for treatment of gynecological diseases. Finally, clinical trials with sulfatase inhibitors are discussed, where two inhibitors have already concluded phase II trials, although so far with no convincing clinical outcomes for patients with endometrial cancer and endometriosis.

  10. Adrenal androgen hyperresponsiveness to adrenocorticotropin in women with acne and/or hirsutism: adrenal enzyme defects and exaggerated adrenarche. (United States)

    Lucky, A W; Rosenfield, R L; McGuire, J; Rudy, S; Helke, J


    To determine the adrenal contribution to elevated plasma androgens in 31 young hyperandrogenemic women with acne and/or hirsutism, we compared their responses to ACTH with those of 14 normal women. Each subject was given a low dose (10 micrograms/m2) of synthetic ACTH-(1-24) (Cortrosyn) after administration of 1.5 mg dexamethasone the night before the test. Thirty and 60 min responses of plasma 17 alpha-hydroxypregnenolone (17-Preg), 17 alpha-hydroxyprogesterone, (17-prog), dehydroepiandrosterone (DHEA), androstenedione, 11-deoxycortisol, and cortisol were measured. Eighteen (58%) patients had increased responses of at least one 17-ketosteroid or adrenal androgen precursor. All patients had cortisol responses within the range of those of the 14 normal subjects. Nine patients (29%) had evidence of steroid biosynthetic enzyme deficiencies, either mild congenital adrenal hyperplasia or the heterozygote state; after ACTH, 4 of these patients had elevated 17-prog in the range of values in heterozygote carriers of 21-hydroxylase deficiency, 2 had elevated levels of 11-deoxycortisol compatible with 11 beta-hydroxylase deficiency, and 3 had elevated levels of 17-Preg and DHEA, suggestive of 3 beta-hydroxysteroid dehydrogenase deficiency. Another 9 subjects (29%) had 17-ketosteroid (DHEA and/or androstenedione) hyperresponsiveness to ACTH with associated elevated 17-Preg responses. As a group, their patterns suggested relatively deficient 3 beta-hydroxysteroid dehydrogenase and relatively hyperactive C lyase without impairment of cortisol secretion. This pattern resembles exaggerated adrenarche, and we postulate that these 9 patients have hyperplasia of the zona reticularis. Neither basal levels of plasma androgens (free testosterone and DHEA sulfate) nor menstrual history predicted which patients would have abnormal ACTH responses. Although 5 of 11 (45%) patients with acne alone had abnormal responses to ACTH, 10 of 14 patients with acne and hirsutism (71%) had abnormal

  11. Adrenal Cortical and Medullar Hyperplasia-A Retrospective Analysis of 6 Cases

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    陈敏; 鲁功成; 张齐均


    Summary: The features of the symptoms, laboratory tests and pathological characteristics of a-drenal cortical and medullary hyperplasia were studied. In 6 cases of hypercatecholaminenia, plas-ma norepinephrine (NE), epinephrine (E), catecholamine (CA) and 24-h urinary vanillylmandelicacid (VMA), 17-hydroxycorticosteroid (OHCS) and 17-ketosteroid (KS) were determined. A-drenal glands were examined by CT scan and 131I-MIBG imaging. Pathological examination wasperformed after operation. The results showed that in 6 cases of hypercatecholaminenia (3 menand 3 women) aged from 34-50 years, the clinical features were just like "pheochromocytoma",for example, episodic headache, perspiration, palpitation, pallor, apprehension, nausea, tremor,anxiety and so on. Plasma levels of CA, NE and E were elevated in all 6 cases. 24-h urinary sam-ples obtained at the onset revealed elevated VMA in 1 case. 24-h urinary cortisol was obviously el-evated in all 6 cases. 24-h urinary 17-OHCS, 17-KS was normal. B-type ultrasound, CT, MRIand 13I-MIBG revealed 9 lateral adrenal gland diffuse or nodular enlargement in 6 cases. Patholog-ic examination showed adrenal cortical and medullary hyperplasia. Clinically, adrenal cortical andmedullary hyperplasia resembled "pheochromocytoma". The most significant feature of this dis-ease was both elevated plasma CA and 24-h urinary cortisol obviously. Pathologic examinationshowed adrenal cortex nodular hyperplasia and medullar diffuse or limit hyperplasia. Whether it isan independent disease or symptoms of the other disease has not final conclusion up till now

  12. Testosterone-secreting adrenal adenoma in a peripubertal girl

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    Kamilaris, T.C.; DeBold, C.R.; Manolas, K.J.; Hoursanidis, A.; Panageas, S.; Yiannatos, J.


    A 15-year-old girl who presented with primary amenorrhea and virilization had an adrenocortical adenoma that secreted predominantly testosterone. To the authors' knowledge, she is the first peripubertal and second youngest patient with a testosterone-secreting adrenal tumor described. Serum dehydroepiandrosterone sulfate and urinary 17-ketosteroid an 17-hydroxycorticosteroid levels were normal. A tumor was located by a computed tomographic (CT) scan and by uptake of 6-..beta..-(/sup 75/Se) selenomethylnorcholesterol. Microscopic examination of the tumor showed typical features of an adrenocortical adenoma with no histologic features characteristic of Leydig cells. Postoperatively, her hirsutism regressed, she rapidly went through puberty, and regular monthly menstruation started four months later. Finding the source of testosterone in a virilized patient can be difficult. Eleven of the 14 previously described patients with testosterone-secreting adrenal tumors initially underwent misdirected surgery on the ovaries. Review of these cases revealed that results of hormone stimulation and suppression tests are unreliable and that these tumors are usually large. Therefore, CT scanning of the adrenal glands is recommended in all patients suspected of having a testosterone-secreting tumor.

  13. Synergistic effect of carbon monoxide with other biologically active injurious factors on the organism

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    Pankow, D.; Ponsold, W.


    The combined effects on biological organisms are reported for carbon monoxide and carbon dioxide, nitrogen oxides, sodium nitrite, hydrocyanic acid, carbon disulfide, sulfur dioxide, ammonia, hydrogen peroxide, ethanol, trichloroethylene, carbon tetrachloride, methane, benzene, iodine acetate, cholesterol, benzpyrene, hexobarbitol, zoxazolamine, nembutal, luminal, morphine, adrenalin, persantin, cytochrome c, aldrin, carbaryl, cyclodiene epoxide; and physical influences such as ambient temperature, atmospheric pressure, ionizing radiation, noise, and vibration. A literature review shows that with increasing CO/sub 2/ and decreasing oxygen concentration in the inhalation air, the toxicity of CO increased in experiments with mice and canaries. Oxides of nitrogen enhance the toxic effect of CO in an additive way and at times synergistically. At 500 m from a metallurgical plant in the USSR the maximum allowable immission concentrations for CO and SO/sub 2/ were exceeded. In children residing there a higher normal erythrocyte number, hemoglobin content, and catalase activity were found in the blood along with higher concentrations of coproporphyrin and 17-ketosteroids. All values returned to normal after an 8-week stay of these children away from the metallurgical plant.

  14. Sympathoadrenal and hypophyseal-adrenal systems in preoperative irradiation of patients with esophageal and cardiac cancer

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    Tarutinov, V.I.; Starosel' skij, I.V.; Gol' dshmidt, B.Ya.; Shmal' ko, Yu.P.; Levchenko, A.M. (Nauchno-Issledovatel' skij Rentgeno-Radiologicheskij i Onkologicheskij Inst., Kiev (Ukrainian SSR))


    A study was made of 74 patients with esophageal and cardiac cancer, Stages 3 and 4. The excretion of catecholamines, corticosteroids and their precursors was studied, tests with adrenalin before and after preoperative irradiation at a summary dose of 30 Gy were done. It has been shown that before the start of radiation therapy the excretion of catecholamines and corticosteroids is lowered, the reaction to adrenalin administration is negative in most patients, the phase syndrome of cardiac hypodynamics associated with disturbed function of the sympathoadrenal system was revealed. Preoperative irradiation in patients with esophageal and cardiac cancer results in an increased excretion of 17-ketosteroids (17-KS) and 17-ketogenic steroids, however 17-KS excretion does not reach the normal level. For better tolerance of irradiation and for a radiosensitization effect testenate is administered to patients before and during radiation therapy. The administration of testenate 7-10 days before the start and during radiotherapy proved to be effective which was confirmed by noticeable necrobiotic and necrotic changes of cancer cells.

  15. Carcinoma of the Adrenal Cortex in Children%小儿肾上腺皮质癌

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    黄澄如; 贺荣友


    @@ 婴幼儿肾上腺皮质功能性病变,表现为使皮质醇症时,多系肾上腺皮质癌.我院1960~1979年共收治4例,均经手术切除.近期2例随访已超过2年,情况良好;1例术后死亡;1例未随访.今简要报导及讨论如下.%Adrenal carcinoma is often responsible for Cushing's syndrome complicated with virilization or isosexual precocity in a male.Usually the carcinoma is large enough to be palpable on examination and can be demonstrated by routine pyelography.Increased level of urinary 17-ketosteroids or 17-hydroxycorticoids and the failure to respond to the dexamethasone suppresion test strongly support the diagnosis of carcinoma.Four patients,two males and two females,with adrenal carcinoma were admitted to this hospital from 1960 to 19799 with the age ranging from 2 to 4 years.

  16. Testosterone metabolism of fibroblasts grown from prostatic carcinoma, benign prostatic hyperplasia and skin fibroblasts

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    Schweikert, H.U.; Hein, H.J.; Romijn, J.C.; Schroeder, F.H.


    The metabolism of (1,2,6,7-3H)testosterone was assessed in fibroblast monolayers derived from tissue of 5 prostates with benign hyperplasia (BPH), 4 prostates with carcinoma (PC), and 3 biopsy samples of skin, 2 nongenital skin (NG) and 1 genital skin. The following metabolites could be identified: androstanedione androstenedione, dihydrotestosterone, androsterone, epiandrosterone, androstane-3 alpha, 17 beta-diol and androstane-3 beta, 17 beta-diol. Testosterone was metabolized much more rapidly in fibroblasts originating from prostatic tissue than in fibroblasts derived from NG. A significantly higher formation of 5 alpha-androstanes and 3 alpha-hydroxysteroids could be observed in fibroblasts from BPH as compared to PC. 17-ketosteroid formation exceeded 5 alpha-androstane formation in BPH, whereas 5 alpha-reduction was the predominant pathway in fibroblasts grown from PC and NG. Since testosterone metabolism in fibroblasts of prostatic origin therefore resembles in many aspects that in whole prostatic tissue, fibroblasts grown from prostatic tissues might be a valuable tool for further investigation of the pathogenesis of human BPH and PC.

  17. Influence of Occupational and Environmental Exposure to Low Concentrations of Polychlorobiphenyls and a Smoking Habit on the Urinary Excretion of Corticosteroid Hormones. (United States)

    D'Errico, Maria Nicolà; Lovreglio, Piero; Drago, Ignazio; Apostoli, Pietro; Soleo, Leonardo


    The effects of occupational exposure to low concentrations of polychlorobiphenyls (PCBs) on the urinary excretion of corticosteroid hormones were evaluated, taking into account the influence of cigarette smoking. The study included 26 males working as electrical maintenance staff in a steel factory, previously exposed to a mixture of PCBs (exposed workers), and 30 male workers with no occupational exposure to PCBs (controls). Serum PCBs (33 congeners), urinary 17-hydroxycorticosteroids, 17-ketosteroids (KS) and pregnanes, and their respective glucuronidated and sulfonated compounds, were determined for each subject. PCBs were significantly higher in the exposed workers than controls, and were correlated with age. Both the urinary concentrations of the total 17-KS and pregnanes, and those of some single steroids and their glucuronidated compounds, were significantly lower in the exposed workers than controls, but higher in smokers than the non-smokers + ex-smokers. Two-way analysis of variance showed a negative association between serum PCBs and both total glucuronidated 17-KS and total and glucuronidated pregnanes, and a positive association between cigarette smoking and both total and glucuronidated 17-KS. PCBs seem to act as endocrine disruptors by reducing the urinary excretion of corticosteroid hormones, particularly of the glucuronidated fraction. Cigarette smoking could boost these effects of PCBs in smokers.

  18. Adrenocortical tumors in children

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    R.C. Ribeiro


    Full Text Available Childhood adrenocortical tumors (ACT are rare. In the USA, only about 25 new cases occur each year. In Southern Brazil, however, approximately 10 times that many cases are diagnosed each year. Most cases occur in the contiguous states of São Paulo and Paraná. The cause of this higher rate has not been identified. Familial genetic predisposition to cancer (p53 mutations and selected genetic syndromes (Beckwith-Wiedemann syndrome have been associated with childhood ACT in general but not with the Brazilian counterpart. Most of the affected children are young girls with classic endocrine syndromes (virilizing and/or Cushing. Levels of urinary 17-ketosteroids and plasma dehydroepiandrosterone sulfate (DHEA-S, which are abnormal in approximately 90% of the cases, provide the pivotal clue to a diagnosis of ACT. Typical imaging findings of pediatric ACT consist of a large, well-defined suprarenal tumor containing calcifications with a thin capsule and central necrosis or hemorrhage. The pathologic classification of pediatric ACT is troublesome. Even an experienced pathologist can find it difficult to differentiate carcinoma from adenoma. Surgery is the single most important procedure in the successful treatment of ACT. The role of chemotherapy in the management of childhood ACT has not been established although occasional tumors are responsive to mitotane or cisplatin-containing regimens. Because of the heterogeneity and rarity of the disease, prognostic factors have been difficult to establish in pediatric ACT. Patients with incomplete tumor resection or with metastatic disease at diagnosis have a dismal prognosis. In patients with localized and completely resected tumors, the size of the tumor has predictive value. Patients with large tumors have a much higher relapse rate than those with small tumors.

  19. 小儿肾上腺皮质腺癌(附7例报告)%Juvenile Adrenal Cortical Carcinoma(a Report of 7 Cases)

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    陈春光; 陈小华


    This paper reports 7 cases of juvenile adrenal cortical carcinoma including 6 cases of functioning tumor and 1 non-functioning tumor. One patient had adrenal virilism,the others present with a mixed glucocorticoid and sex steroids dyshormonal syndrome. The histopathological changes of this tumor don't always accord with its biological behavior,so a correct diagnosis may be delayed. It is suggested that adrenal cortical carcinoma be considered when 24-hour urinary excretion of 17-ketosteroids exceeding 20mg,inhibition test with large-dose dexamethasone failing to achieve and the diameter of tumor above 5cm with irregular border and uneven density. An early surgical removal of the tumor,appropriate combined chemotherapy,or/with radiotherapy are the important procedure to increase the curative effect.%报告小儿肾上腺皮质腺癌7例,其中功能性6例,非功能性1例.性征异常1例,其余表现为糖皮质激素和性激素混合性分泌紊乱综合征.细胞形态学改变与生物学行为有时并不一致,会造成延误诊断.24小时尿17-KS超过69.4 μmol,大剂量地塞米松抑制试验不能被抑制,肿瘤直径>5 cm,边缘不规则,密度不均匀,应考虑肾上腺皮质恶性肿瘤.早期肿瘤切除,配合联合化疗、放疗以提高疗效.

  20. Management of hirsutism. (United States)

    Callan, A


    This discussion of the management of hirsutism focuses on clinical assessment, investigations, evaluation of treatment methods, therapeutic regimens, medical therapy, cosmetic therapy, and supportive therapy for hirsute women. Initial clinical evaluation of the hirsute woman should consider the site, type, and extent or area of hair growth as well as age of onset and rate of appearance. In part what is normal is determined by societal attitudes and cultural norms, and it may be that a woman seeking treatment for hirsutism is simply over concerned by a normal growth pattern. A well defined coarse growth of hair on the chin and cheeks of sudden onset at any age suggests an underlying endocrine problem, whereas women with fine downy facial hair, even when this is extensive, are less likely to have an endocrine disturbance than those with a coarse growth. Data about family history, ethnic background, age of onset, and rate of appearance will help identify those cases needing more detailed investigation. Physical examination included pelvic examination to exclude ovarian enlargement and examination of genitals to exclude clitoral hypertrophy together with assessment of the overall severity of hirsutism will further define those patients who require further investigation. Urinary 24 hour 17 ketosteroid excretion and plasma androgens should be estimated as a baseline investigation to identify those patients whose hirsutism is due to androgen secreting tumors or adrenal hyperplasia. Testosterone production rate and testosterone metabolic clearance rate have been shown to be well increased in hirsute women and to correlate well with severity of hirsutism. In certain patients laboratory evidence may suggest either the ovaries or the adrenals as the major source of androgen excess. The ideal response to treatment is reduced growth rate and reversion of coarse, dark, terminal hair to a lighter, more downy growth. There is no uniformly reliable, simple, objective method of

  1. The biochemical study of intermaxillary fixation (IMF) stress in oral surgery inpatients. (United States)

    Sakaino, H


    Although intermaxillary fixation (IMF) is performed to treat the patients with maxillary fracture, this procedure is very stressful to the patients. IMF has been reported to increase noradrenaline (NA) release in the brain and elevate plasma corticosterone contents in the rat. These changes were significantly attenuated by diazepam, an anxiolytic of the benzodiazepine family. These results suggest that IMF could greatly affect the pituitary-adrenal system as a stress. In the present study, in order to examine the influence of IMF on the human body function, we measured levels of 17-hydrocorticosteroids (17-OHCS) and 17-ketosteroid (17-KS), which are metabolites of the adreno-cortical hormone cortisol, in the urine of inpatients undergoing IMF. The subjects were requested to fill out a questionnaire on irritableness caused by IMF. In these patients, urinary 17-OHCS levels were significantly increased after IMF and well correlated to the results of the questionnaire. The finding suggested that urinary 17-OHCS levels reflect stress related to IMF, and that such stress mainly causes an irritated feeling. Natural killer cell activity (NK activity), which is considered to be related to stress, was measured in these patients. The relationship between 17-OHCS levels and NK activity was examined in reference to the results of the questionnaire. Questionnaire showed that most patients noted insomnia and an irritated feeling during IMF. To examine the influence of anxiolytic agents on stress related to IMF, an anxiolytic agent, ethyl loflazepate, was administered during IMF, and urinary 17-OHCS levels were measured. There was no correlation between 17-OHCS levels and NK activity in the patients. Furthermore, no correlation was observed between visual analogue scale (VSA) and NK activity. Increases in 17-OHCS levels in the group treated with ethyl loflazepate, an anxiolytic of the benzodiazepine family, were significantly lower than in the untreated group. This suggests that

  2. [Male pseudohermaphroditism caused by enzymatic deficiency of 17-alpha-hydroxylase. 1st case reported in Puerto Rico]. (United States)

    Rosado, A; Alegre, M; Colón, G


    A 36 year old white female came to our service after having been evaluated on repetitive occasions in the past for a workup of gigantism and acromegalic features. Since childhood she had developed tall stature, frontal bossing, prominence of zygomatic bones, separated teeth, large hands and size 14 shoes. Human growth hormone and somatomedin serum levels had been normal on all occasions tested. Her past history was significant for primary amenorrhea and a 12 year history of hypertension. On physical examination BP was 140/100, height 6' 2", weight 2571 bs. Her phenotype was truly acromegalic. There was absence of axillary and pubic hair with no breast development. External genitalia was of female appearance. Laboratory evaluation showed increased FSH of 88 mlU/ml, increase LH of 65.6 mlU/ml and decreased E2 of 12.6 pg/ml. Other findings were low serum cortisol of 0.2 mg/dl, high ACTH of 344 pg/ml, low 17-Ketosteroids, high pregnenolone levels of 595 mg/dl, low 17-hydroxypregnenolone less than 10 ng/dl, very high aldosterone of 31 ng/dl and suppressed PRA of less than 0.1 ng/ml. A pelvic sonogram showed a right ovoid structure which could represent a gonad and failed to identify the uterus and left gonad. A bone densitometry showed a decrease bone mineral density compatible with osteoporosis. Chromosome study showed a karyotype of 46-XY. A diagnosis was made of congenital adrenal hyperplasia secondary to 17-alpha-hydroxylase deficiency in a genotypic male. Our patient was referred to the department of gynecology for surgical removal of the gonads. It is amazing how a patient with severe adrenal insufficiency can withstand 36 years of her life undiagnosed without going into an adrenal crisis. Her tall stature and acromegalic features were the striking signs confusing all physicians and delaying the correct diagnosis and appropriate treatment. There has been reported worldwide, nearly 120 cases with documented severe 17-alpha-hydroxylase deficiency. To our knowledge

  3. 泌尿外科常用术语英文缩写(之三)

    Institute of Scientific and Technical Information of China (English)


    (续第15卷第9期第433页) IA idiopathic Addison's disease 特发性阿狄森氏病 IAH idiopathic adrenal hyperplasia 特发性肾上腺增生 IBI intermittent bladder irrigation 间歇性膀胱灌注法 IC ion chromatography 离子色谱(法) ICT immunoreactive calcitonin 免疫反应性降钙素 ID idiotype 个体基因型 IEC intraepithelial carcinoma 上皮内癌 IF intrinsic factor 内因子 Ig immunoglobulin 免疫球蛋白 IHC idiopathic hypercalcemia 特发性高钙血 IHC idiopathic hypercalciuria 特发性高钙尿 IL-2 interleukin-2 白细胞介素2 IMP incomplete male pseudohermaphroditism 不完全性 男性假两性畸形 INF interferon 干扰素 IP intravenous pyelography 静脉肾盂造影术 IPARF idiopathic postpartum acute renal failure 特发性 产后急性肾功能衰竭 IS index of sexuality 性指数 ITFS incomplete testicular feminization syndrome 不完 全性睾丸女性化综合征 IVF in vitro fertilization 体外受精 IVP intravenous pyelography 静脉(或排泄性)肾盂造影 术 IVU intravenous urography 静脉尿路造影术 K 17-K 17-ketosteroid 17-酮类固醇 KFAB kidney-fixing antibody 肾结合抗体 KGT kidney glucosidetransferase 肾葡萄糖苷转移酶 KUB kidneys,ureters,bladder 肾,输尿管,膀胱 L LAD lactic acid dehydrogenase 乳酸脱氢酶 LAF lymphocyte activating factor 淋巴细胞活化因子 LAG lymphangiogram 淋巴管造影照片 LASER light amplification by stimulated emission of ra- diation (Laser) 激光 LC liquid chromatography 液相色谱(法 LDH lactate dehydrogenase 乳酸脱氢酶 LGV lymphogranuloma venereum 性病性淋巴肉芽肿 LH luteinizing hormone 促黄体(生成)激素 LK left kidney 左肾 LU left ureter 左输尿管 Lues I primary syphilis 一期梅毒 Lys lysine 赖氨酸 M M male 男性,雄性 MA membrane antigen 膜抗原 MC mineralocorticoid (肾上腺)盐皮质激素 MMC mitomycin 丝裂霉素 McAb monoclonal antibody 单克隆抗体 MDR multidrug resistance