Determination of Total 17-Hydroxycorticoids in Plasma*†

Cushing' Disease: Management by Transsphenoidal Pituitary Microsurgery*

“…Serum cortisol, 11-deoxycortisol (compound S), urinary 17OHCS, urinary 17-ketosteroids, T 3 , T 4 , PRL, LH, FSH, and serum glucose measurements were performed according to previously published methods (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Dexamethasone suppression tests, metyrapone tests, TRH, gonadotropin-releasing hormone (LHRH), and insulin tolerance tests were performed as previously reported (10,21,(22)(23)(24).…”

A Method for Routine Assay of Plasma 17-Hydroxycorticoids and 17-Ketosteroids

“…It enables us: a) to determine the unchanged and more direct secretion of the adrenal compounds. Reddy (14) writes: "It is clear that studies of adrenal secretion should ideally include measurements of both free and conjugated adrenal steroids in blood and urine"; b) to measure changes of adrenal activity oc curring in sudden variation of environment or in sudden stress condition; c) to avoid the known difficulties with the patient of collecting whole amounts of 24 hours urine.…”

“…But all of the methods employing en zymatic hydrolysis with glucoronidase are not entirely reliable, since a) it is not known to what extent the 17-OHCS are quanti tatively liberated by glucuronidase, and b) other conjugated forms than glucuronates are not determined. Reddy et al (14) determine by their method the total 17-OHCS. As to the determination of 17-KS in plasma, reports in the literature are contradictory: West el al.…”

Endocrinology

“…This is apparently the case (468,484,485,508,509,510) . It is of interest that the slow rate of disappearance from plasma of administered cortisol in hepatic disease can be shown to be associated with a reduced rate of conjugate formation (484,485).…”