Studies in Cushing's Syndrome. Iii. Urinary 17-Ketosteroids in Patients With Bilateral Adrenal Cortical Hyperplasia*

The Excretion of Individual 17-Oxosteroids in Cushing's Syndrome

“…This elevation of the 5/?/5oc ratio has been observed previously (Pond, 1954;Baulieu, Huis in't Veld, Jaoudé & Jayle, 1957;Jailer et al 1959), and may not be confined to the C-19 steroids, since Bush & Willoughby (1957) also observed a relative increase in the 5/3/5a ratio of the tetrahydro derivatives of cortisol excreted by patients with mild Cushing's syndrome. Jailer et al (1959) were also able to demonstrate this abnormality in the oxosteroids excreted by two patients treated over long periods with ACTH. This was not confirmed in the one patient studied here after ACTH treatment, but this may be related to the degree of stimulation; in terms of cortisol secretion this particular patient was producing less steroid than any of the subjects with Cushing's syndrome.…”

“…Jailer et al (1959) have considered the evi¬ dence for an abnormal precursor, and favour a C-21 steroid such as Reichstein's substance S. This is known to be metabolized to aetiocholanolone, and its tetra¬ hydro derivative (THS) has occasionally been reported as an excretion product in Cushing's syndrome. However, THS should be detected with greater regularity if substance S were consistently a component of the adrenocortical secretion in these patients.…”

“…Jailer et al 1959). It can be seen that the excretion of 11-oxygenated 17-oxosteroids (11/3-hydroxyaetiocholanolone, llß-hydroxyandrosterone and 11-oxoaetiocholanolone) is above the normal range in each case.…”

Androgen Release and Synthesis in Vitro by Human Adult Adrenal Glands*

“…This paper is a report of 1) isolation, measurement, and identification of adrenal androgens released into the incubation media with slices alone and with the addition of radioactive steroid precursors and 2) the in vitro effect of ACTH on androgen release and substrate conversion. Studies of corticosteroid production and biosynthesis by some of these tissue slices were reported previously ( 11,27 (31). The clinical impression of adrenal virilism (patients E.S.…”

Cushing's Syndrome. IV. Urinary 17-Ketosteroids in Patients with Adrenal Cortical Tumors.

“…A similar study of urinary 17-ketosteroids in Cushing's syndrome associated with bilateral adrenal cortical hyperplasia has been carried out ( 1 ) . A similar study of urinary 17-ketosteroids in Cushing's syndrome associated with bilateral adrenal cortical hyperplasia has been carried out ( 1 ) .…”