URINARY EXCRETION OF 17-KETOSTEROIDS IN VARIOUS CONDITIONS OF OLIGOPHRENIA CORRELATED WITH SOME AUTOPSY OBSERVATIONS

Abstract

URINARY 17-ketosteroid excretion as a measure of adrenal cortical activity plus male gonadal activity has attracted much attention in recent years, and standards for adults (6) and children (13) have been well established. As a method of diagnosing abnormal adrenal cortical activity in such conditions as hyperadrenocorticism (Cushing's disease), adrenal cortical tumors; hypoadrenocorticism (Addison's disease); male hypergonadism (Leydig cell tumors); and hypogonadism and panhypopituitarism the determination of 17-ketosteroids in the urine has considerable clinical importance. Hypogonadism in the male is reflected by low (female) values of 17-ketosteroid excretion, as seen in gynecomastia (9), cretinism, and mongolism (3, 13). Abnormalities in 17-ketosteroid excretion in certain psychoses, indicating a faulty adrenal cortical response to stress, have been observed by Hoagland and Pincus (8), and low values in diabetes have been reported by Miller and Mason (10). The excretion of 17-ketosteroids in various types of mental deficiency has not yet been the subject of intensive research. Such a study seems of interest for several reasons. Although mental deficiency in its many degrees and variations does not represent a uniform morbid entity, observations indicate that it is very frequently associated with a general constitutional inferiority, malformations and anomalies of development occurring in many organs. While female morons are readily susceptible to impregnation, male morons usually appear sexually rather inactive and lower grade defectives are thought by many observers to be sterile. Of the fortyeight states of the Union, about thirty-one have some kind of sterilization law at present. Several northern European countries such as Denmark, Norway and Sweden have also accepted laws of this type. If the excretion of 17-ketosteroids in males were a true indication of gonadal activity, analyses would be helpful in selecting necessary cases and in determining the need or advisability of sterilization.