性腺外エストロゲンに就いての研究
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概要
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Variation of output of urinary estrogens before and after oophorectomy or adrenalectomy, or both, in patients with uterine cancer, recurrent or metastatic breast cancer, have been observed by using modified Ittrich's chemical method of estimation. Concurrently, the following have also been investigated : <BR>1. The effects of administration of ACTH, PMS, HCG, corticoids and synthesized gestagen (norethindrone), on the excretion of estrone, estradiol-17β, and estriol in urine.<BR>2. The problems of estrogen metabolism in human liver, in patients with breast cancer, after castration, right adrenalectomy and anastomosis of the left adrenal vein with renal vein, and of secretion of estrogens from the ovaries in postmenopausal women after adrenalectomy.<BR>3. The effects of subtotal adrenalectomy against Cushing's disease on the symptoms and estrogen milieu.<BR>The following results have been obtained : <BR>1) It was found that there is an abrupt decrease in the output of urinary estrogens soon after oophorectomy, and that the recovery of urinary estrogen level noted after a while, and stabilized due mainly to recovered estriol value. As a result of a decrease in estradiol-estrone fractions and relative increase in estriol fraction, higher quotient of ET/EO+ED was observed after oophorectomy.<BR>2) Marked increase in the output of urinary estrogens, particularly of estriol fraction was observed when ACTH was administered to castrated women with intact adrenals. No apparent response to the administration of gonadotropin after oophorectomy was obtained.<BR>3) Marked decrease in the output of urinary estrogens, particularly of estriol fraction when prednisolone and dexamethasone was administered to castrated women.<BR>4) Decrease in amount of estriol in urine when small doses of norethindrone were administered to castrated women.<BR>Increase in the output of urinary estrogens, mostly of estrone fraction, followed by an increase in estradiol fraction when large doses of norethindrone were administered to castrated women or castrated combined with adrenalectomy.<BR>It is assumed that this is due to extraglandular conversion of 19 norsteroids, particularly to estrone first and then estradiol-17β.<BR>5) Further reduction in the output of urinary estrogens (mean value, 3.7μg/day) have been observed and no response was seen with ACTH after oophorectomy and adrenalectomy.<BR>6) On the other hand, a slight increase in the output of urinary estrogens has been observed when ACTH was administered to castrated women with right adrenalectomy and anastomosis of the left adrenal vein with renal vein. This is probably due to a gradual process of the estrogen molecule disintegration in human liver and an overflow-phenomenon beyond its capacity.<BR>7) There was a maintenance of excretion of small amounts of estrogens in urine. Still secreted from the ovaries in postmenopausal women after adrenalectomy.
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