抗炎症性合成ステロイドホルモンによる副腎皮質機能抑制に関する研究 (第1報):特に尿中総17-KS及び17-KS分画の変動について
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In order to elucidate the mechanism of iatrogenic hypoadrenocorticism the author studied the changes in urinary 17-KS and its fractions in patients following the treatment with Dexamethasone.<BR>Methods : For the determination of urinary total 17-KS, Callow and Callow's method modified<SUP>48</SUP>) by Forsham was used. Urinary 17-KS fractions were measured by Ono's<SUP>14</SUP>) three-step acid hydrolysis method.<SUP>14</SUP>) The classification of 17-KS fractions was followed after Dingemanse's criteria.<BR>Results : 1) Urinary 17-KS of 10 normal subjects from 15 to 29 years old were 14.5 ± 2.17 (S.D.) mg/day in males and 11.5± 2.27 mg/day in females. Those of 10 normal subjects, from 30 to 60 years old were 12.6± 2.17 mg/day in males and 11.3± 2.35 mg/day in females. (Table 1. A.) Daily variations of urinary 17-KS in the same individuals remaind within 30% during a one-week observation. (Table 1. B.) <BR>2) The patterns of 17-KS fractions were individually different and without significant difference in sex. (Table 3.) The patterns of the fractions in the same individuals were observed to be practically constant at one-week intervals. (Table 2. A.) <BR>3) Following the intravenenous administration of 30 I. U. ACTH, urinary 17-KS and total 17-OHCS were markedly increased where the significant increases in the fractions VI + VII and III were observed. (Table 4.) <BR>4) Urinary 17-KS and its fractions in patients with liver diseases, kindney diseases and diabetes mellitus showed no significant change during their course except with anti-inflammatory steroid. (Table 2. B.) <BR>5) No significant change in urinary 17-KS and patterns of its fractions was found in the subjects treated with 0.75 mg per day of Dexamethasone for 5 days or with 1.5 mg per day for 2 days. After treatment with 0.75 mg per day of Dexamethasone for more than 10 days and with 1.5 mg per day for more than 3 days, urinary 17-KS decreased less than 70% of the initial values within 5 days, where significant decreases were observed in the fractions II, III, IV + V and the ratios IV/V. (Table 5. 6. 7. 8. 9. 10. 11. Fig. 1. 2. 3. 4. 5. 6. 7. 8. 9. 11.) <BR>6) As shown in Fig. 10, a significant correlation between the duration of the Dexamethasone treatment, 1.5 mg per day, and the days required for the recovery from the urinary 17-KS depression.<BR>7) As shown in Table 12, urinary 17-KS and its fractions in patients with large doses of Dexamethasone recovered from their depressed states 2 month after the cessation of the treatment.
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