Table 1. Clinical Background of Studied Cases.

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2 Table 1. Clinical Background of Studied Cases.

3 Table 2. Dexamethasone and Gonadotropins Administration to the Menstrual Disorded Cases Fig. 1. Determination Method for Winary 17-ketosteroids Fractions

4 Table Individual 17-ketosteroids Fractions separated on Silica gel G * This Abbreviation were used throughout this paper. Table 4. Urinary Total 17-KS Level in Normal Female (Proliferative phase)

5 Table 5. Urinary Total 17-KS in 24hrs (mg/day) Fig. 2. Urinary Total 17-KS in 24 hrs. * ƒ denate values in case of testicular feminization. Table 6. Urinary 17-KS Fraction Value, Normal Female, Proliferative Phase (mg/day)

6 Table Ketosteroids Fractions Values in Cases with Menstruai Disorder (Đg/24 brs) Fig KS Frac tions Values of Cases with Menstrual Disor der.

7 Fig. 4. Androstendione in Urine/24 hrs. * See Footnot to Fig. 2. Fig. 5. ƒ 4-Androstendione Fract. in Urine/24 hrs. Fig. 6. Androsterone in Urine/24 hrs. Fig. 7. DHA in Urine/24 hrs. Fig. 8. Etiocholanolone in Urine/24 hrs.

8 Table 8. Ratio of Androsterone, BRA & Etiocholanolone to Total 17-KS Fractions. Table OXY-17KS Valume & 11-OXY/11-DEOXY Ratio. Fig. 9. Androsterone Ratio to Total 17-KS

9 Fig. 10. DHA Ratio to Total 17-KS * See footnote to Fig. 2. Fig. 11. Etiocholanolone Ratio to Total 17-KS Fig. 12. Urinary 11-oxy-17-KS in 24 hrs. Fig oxy/11-deoxy ratio

10 Table 10. Total 17-KS and Androsterone Ratio on Dynamic Test Cont. =Control Period DXM=Supressed by DXM DXM. +Gt. =Stimulated with Gonadtropina under Adrenal Supressed. Fig. 14. Urinary Total 17-KS on Adrenal Suppression and Gonadal Stimulation Test Fig. 15. Androsterone Ratio to Total 17-KS on Adrenal Suppression and Gonadal Stimulation Test

11 Fig. 16. DHA Ratio to Total 17-KS Fig. 17. Androsterone Ratio to Total 17-KS

12

13 1) Bernfeld, P., Nisselbaum, J. S., & Fishman, W, H.: J. B. C., 202: 757, (1953). 2) Cooke, B. J. E.: Practitioner, 94: 254, (1965). 3) Dorfman, R. I.: Biochemistry of Steroids, Per gamon Press (1959). 4) Goldzieher, J. W. & Green, J. A.: J. C. E., 22: 425, (1962). 5) Lanthier, A: J. C. E., 20: 1589, (1960). 6) Netter, A. P.: Proc. Roy. Soc. Med., 54: 1, 006, (1961). 7) Personen, S.: Acts, Endocr., 43: 220, (1963). 8) Savard, K., Dorfman, R. I. & Pontase, E.: J. C, E., 12: 935 (1952). 9) Vignalou, J., Lemarchal, A. & Plouin, S.: Proc. of 2nd International Congress of Edocr., p. 957, (1964). Studies on Urinary Fractional 17-ketosteroids in Menstrual Disorder By Akira UNO Dept. of Obst. and Gynce., Okayama University Medical School (Director: Professor Kiyoshi Hashimoto) Reently, it has been discussed the menstrual disorder caused by deranged metabolism of androgens in ovaries. While the derangement may not be demonstrable by urinary total 17-KS estimation, it is necessary to study urinary 17-KS in detail such as 1) fractionation study of 17-KS, 2) adrenal suppression and gonadal stimulation, dynamic test, after Netter, 3) ratio analysis of specific 17-KS fraction, as androsterone or DHA (dehydoepiandrosterone), to total 17-KS. The ratio analysis of urinary 17-KS after Yoshida were performed in 32 cases of menstr ual disorder and 19 carses of normal female in proliferative phase and dynamic test was com bined in 15 cases of menstrual disorder. 1) Specific change in urinary total 17-KS level has not been observed in the cases of menstrual disorder. 2) Urinary 17-KS fractions also did not show specific excretion pattern in these patients. 3) The ratio analysis of androsterone/total 17-KS and DIIA/total 17-KS clearly revealed deranged metabolism of androgens in Primary amenorrhea patients. 4) The ratio analysis combined dynamic test demonstrated more clearly the deranged metabolism. As the conclusion, it should be emphasized that the ratio analysis and the dynamic test were required in evaluating deranged steroid metabolism.

rectomy as the subjects of study, urinary steroid hormones were measured, and simultaneously the enzyme work and enzyme pattern related to the steroid metabolism, as proposed by Yoshida of our laboratory,

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