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Studies of 17-Hydroxycorticosteroids: XIV. Plasma 17-Hydroxycorticosteroid Concentrations at Death in Human Subjects

Studies of 17-Hydroxycorticosteroids: XIV. Plasma 17-Hydroxycorticosteroid Concentrations at... Abstract Markedly elevated circulating concentrations of 17-hydroxycorticosteriods (17-OHCS) have been found by a number of workers1-6 in patients with terminal illnesses. However, little is known concerning factors which may influence responsiveness of the pituitary-adrenal system to impending death. The purpose of this communication is to present observations concerning the relationship of such factors as age, chronicity of illness, nature of the disease process, mode of death, and previous corticoid therapy to plasma concentrations of 17-OHCS at death in human subjects. Methods Sixty-four patients ranging in age from ½ hour to 90 years were utilized in this study. The new-born infants were full-term, except as indicated in Table 1. Blood samples were obtained by cardiac puncture, usually within 5 minutes and in all cases within 20 minutes after death. In addition, serial blood specimens were obtained prior to death from six patients with craniocerebral trauma. Plasmas were separated by centrifugation and References 1. Nelson, D. H.; Samuels, L. T.; Willardson, D. G., and Tyler, F. H. The Levels of 17-Hydroxycorticosteroids in Peripheral Blood of Human Subjects , J. Clin. Endocrinol. 11:1021 ( (Sept.) ) 1951.Crossref 2. Perkoff, G. T.; Sandberg, A. A.; Nelson, D. H., and Tyler, F. H.: Clinical Usefulness of Determination of Circulating 17-Hydroxycorticosteroid Levels , A. M. A. Arch. Int. Med. 93:1 ( (Jan.) ) 1954.Crossref 3. Bayliss, R. I. S.: Factors Influencing Adrenocortical Activity in Health and Disease , Brit. M. J. 1:495 ( (Feb. 26) ) 1955.Crossref 4. Wallace, E. Z.; Christy, N. P., and Jailer, J. W.: Clinical Application of the Simplified Silber-Porter Method for Determining Plasma 17-Hydroxy-Corticosteroids , J. Clin. Endocrinol. 15: 1073 ( (Sept.) ) 1955.Crossref 5. Migeon, C. J.; Sandberg, A. A.; Bliss, E. L., and Keller, A. R.: Non-Conjugated Adrenocortical Steroids in Human Plasma: Comparison of the Nelson and Samuels Method with Paper Chromatographic Techniques , J. Clin. Endocrinol. 16:253 ( (Feb.) ) 1956.Crossref 6. Sandberg, A. A.; Eik-Nes, K.; Migeon, C. J., and Samuels, L. T.: Metabolism of Adrenal Steroids in Dying Patients , J. Clin. Endocrinol. 16:1001 ( (Aug.) ) 1956.Crossref 7. Nelson, D. H., and Samuels, L. T.: A Method for the Determination of 17-Hydroxycorticosteroids in Blood: 17-Hydroxycorticosterone in the Peripheral Circulation , J. Clin. Endocrinol. 12: 519 ( (May) ) 1952.Crossref 8. Eik-Nes, K.; Nelson, D. H., and Samuels, L. T.: Determination of 17-21-Hydroxycorticosteroids in Plasma , J. Clin. Endocrinol. 13:1280 ( (Oct.) ) 1953.Crossref 9. Ely, R. S.; Hughes, E. R., and Kelley, V. C.: Studies of Adrenal Corticosteroids: I. Estimation of Plasma Corticosterone and Cortisol , J. Clin. Endocrinol. 18:190 ( (Feb.) ) 1958.Crossref 10. Sweat, M. L.: Sulfuric Acid-Induced Fluorescence of Corticosteroids , Analyt. Chem. 26:773 ( (April) ) 1954.Crossref 11. Sweat, M. L.: Silica Gel Microcolumn for Chromatographic Resolution of Cortical Steroids , Analyt. Chem. 26:1964 ( (Dec.) ) 1954.Crossref 12. Ely, R. S.: The Evaluation of Pituitary-Adrenal Function , in Essays on Pediatrics , edited by R. A. Good and E. S. Platou, Minneapolis, Lancet Publications, 1955, p. 86. 13. Bongiovanni, A. M.: Physiology of the Adrenal Cortex in Infancy and Childhood , Am. J. M. Sc. 222:710 ( (Dec.) ) 1951.Crossref 14. Klein, R.: Some Aspects of Adrenal Physiology in the Newborn Period and in Early Infancy , in Proceedings of the Second Clinical ACTH Conference , edited by J. R. Mote, New York, The Blakiston Company, 1951, Vol. 1, p. 123. 15. Klein, R., and Rovnanek, A.: ACTH Response in Newborn Infants , in Adrenal Function in Infants and Children: A Symposium , edited by L. I. Gardner, New York, Grune & Stratton, Inc., 1956, pp. 46-57. 16. Eagle, J. F., and Wolfson, W. Q.: Human Corticosterone Metabolism: IV. Probable Predominance of Corticosterone in the Adrenocortical Secretion of Premature Infants , J. Lab. & Clin. Med. 43:831 ( (June) ) 1954. 17. Eagle, J. F.: Discussion , in Adrenal Function in Infants and Children: A Symposium , edited by L. I. Gardner, New York, Grune & Stratton, Inc., 1956, pp. 41-44. 18. Ulstrom, R. A., and Doeden, D.: Chromatographic Studies of Urinary Steroids in Term and Premature Infants , in Adrenal Function in Infants and Children: A Symposium , edited by L. I. Gardner, New York, Grune & Stratton, Inc., 1956, pp. 31-40. 19. Thornton, M.; Hughes, E. R.; Ely, R. S., and Kelley, V. C.: The Changing Pattern of Adrenal Corticosteroids from Birth to Maturity, read before the Society for Pediatric Research, Quebec, Canada, June 15, 1955. 20. Harris, G. W.: Neural Control of the Pituitary Gland , Physiol. Rev. 28:139 ( (April) ) 1948. 21. Harris, G. W.: Neural Control of the Pituitary Gland: II. The Adenohypophysis , Brit. M. J. 2:627 ( (Sept. 15) ) 1951. 22. Symington, T.; Currie, A. R.; Curran, R. C., and Davidson, J. N.: The Reaction of the Adrenal Cortex in Conditions of Stress , in Ciba Foundation Colloquia on Endocrinology , Vol. 8, edited by G. E. W. Wolstenholme and M. P. Cameron, Boston, Little, Brown & Company, 1955. 23. Sayers, G., and Sayers, M. A.: The Pituitary-Adrenal System , in Recent Progress in Hormone Research , Vol. 2, edited by G. Pincus, New York, Academic Press, Inc., 1948, p. 81. 24. Hume, D. M., and Wittenstein, G. J.: The Relation of the Hypothalamus to Pituitary-Adrenocortical Function , in Proceedings of the First Clinical ACTH Conference , edited by J. R. Mote, Philadelphia, The Blakiston Company, 1950, p. 134. 25. Graham, B. F., and Cleghorn, R. A.: Changes in the Circulating Leukocytes Following Electrically-Induced Convulsions in Man , J. Clin. Endocrinol. 11:1469 ( (Dec.) ) 1951. 26. Rosvold, H. E.; Kaplan, S. J., and Stevenson, J. A. F.: Effects of Electro-Convulsive Shock on Adrenal Cortex of the Rat , Proc. Soc. Exper. Biol. & Med. 80:60 ( (May) ) 1952. 27. Sayers, G., and Burke, R.: Blood ACTH During Ether Anesthesia , Fed. Proc. 14:131 ( (March) ) 1955. 28. Egdahl, R. H.; Nelson, D. H., and Hume, D. M.: Effect of Hypothermia on 17-Hydroxycorticosteroid Secretion in Adrenal Venous Blood in the Dog , Science 121:506 ( (April 8) ) 1955. 29. Eik-Nes, K.: Adrenocortical Activity and Metabolism of 17-Hydroxycorticosteroids in Anesthetized Dogs Exposed to Cold , Fed. Proc. 14:336 ( (March) ) 1955. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

Studies of 17-Hydroxycorticosteroids: XIV. Plasma 17-Hydroxycorticosteroid Concentrations at Death in Human Subjects

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Publisher
American Medical Association
Copyright
Copyright © 1958 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1958.02060060657002
Publisher site
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Abstract

Abstract Markedly elevated circulating concentrations of 17-hydroxycorticosteriods (17-OHCS) have been found by a number of workers1-6 in patients with terminal illnesses. However, little is known concerning factors which may influence responsiveness of the pituitary-adrenal system to impending death. The purpose of this communication is to present observations concerning the relationship of such factors as age, chronicity of illness, nature of the disease process, mode of death, and previous corticoid therapy to plasma concentrations of 17-OHCS at death in human subjects. Methods Sixty-four patients ranging in age from ½ hour to 90 years were utilized in this study. The new-born infants were full-term, except as indicated in Table 1. Blood samples were obtained by cardiac puncture, usually within 5 minutes and in all cases within 20 minutes after death. In addition, serial blood specimens were obtained prior to death from six patients with craniocerebral trauma. Plasmas were separated by centrifugation and References 1. Nelson, D. H.; Samuels, L. T.; Willardson, D. G., and Tyler, F. H. The Levels of 17-Hydroxycorticosteroids in Peripheral Blood of Human Subjects , J. Clin. Endocrinol. 11:1021 ( (Sept.) ) 1951.Crossref 2. Perkoff, G. T.; Sandberg, A. A.; Nelson, D. H., and Tyler, F. H.: Clinical Usefulness of Determination of Circulating 17-Hydroxycorticosteroid Levels , A. M. A. Arch. Int. Med. 93:1 ( (Jan.) ) 1954.Crossref 3. Bayliss, R. I. S.: Factors Influencing Adrenocortical Activity in Health and Disease , Brit. M. J. 1:495 ( (Feb. 26) ) 1955.Crossref 4. Wallace, E. Z.; Christy, N. P., and Jailer, J. W.: Clinical Application of the Simplified Silber-Porter Method for Determining Plasma 17-Hydroxy-Corticosteroids , J. Clin. Endocrinol. 15: 1073 ( (Sept.) ) 1955.Crossref 5. Migeon, C. J.; Sandberg, A. A.; Bliss, E. L., and Keller, A. R.: Non-Conjugated Adrenocortical Steroids in Human Plasma: Comparison of the Nelson and Samuels Method with Paper Chromatographic Techniques , J. Clin. Endocrinol. 16:253 ( (Feb.) ) 1956.Crossref 6. Sandberg, A. A.; Eik-Nes, K.; Migeon, C. J., and Samuels, L. T.: Metabolism of Adrenal Steroids in Dying Patients , J. Clin. Endocrinol. 16:1001 ( (Aug.) ) 1956.Crossref 7. Nelson, D. H., and Samuels, L. T.: A Method for the Determination of 17-Hydroxycorticosteroids in Blood: 17-Hydroxycorticosterone in the Peripheral Circulation , J. Clin. Endocrinol. 12: 519 ( (May) ) 1952.Crossref 8. Eik-Nes, K.; Nelson, D. H., and Samuels, L. T.: Determination of 17-21-Hydroxycorticosteroids in Plasma , J. Clin. Endocrinol. 13:1280 ( (Oct.) ) 1953.Crossref 9. Ely, R. S.; Hughes, E. R., and Kelley, V. C.: Studies of Adrenal Corticosteroids: I. Estimation of Plasma Corticosterone and Cortisol , J. Clin. Endocrinol. 18:190 ( (Feb.) ) 1958.Crossref 10. Sweat, M. L.: Sulfuric Acid-Induced Fluorescence of Corticosteroids , Analyt. Chem. 26:773 ( (April) ) 1954.Crossref 11. Sweat, M. L.: Silica Gel Microcolumn for Chromatographic Resolution of Cortical Steroids , Analyt. Chem. 26:1964 ( (Dec.) ) 1954.Crossref 12. Ely, R. S.: The Evaluation of Pituitary-Adrenal Function , in Essays on Pediatrics , edited by R. A. Good and E. S. Platou, Minneapolis, Lancet Publications, 1955, p. 86. 13. Bongiovanni, A. M.: Physiology of the Adrenal Cortex in Infancy and Childhood , Am. J. M. Sc. 222:710 ( (Dec.) ) 1951.Crossref 14. Klein, R.: Some Aspects of Adrenal Physiology in the Newborn Period and in Early Infancy , in Proceedings of the Second Clinical ACTH Conference , edited by J. R. Mote, New York, The Blakiston Company, 1951, Vol. 1, p. 123. 15. Klein, R., and Rovnanek, A.: ACTH Response in Newborn Infants , in Adrenal Function in Infants and Children: A Symposium , edited by L. I. Gardner, New York, Grune & Stratton, Inc., 1956, pp. 46-57. 16. Eagle, J. F., and Wolfson, W. Q.: Human Corticosterone Metabolism: IV. Probable Predominance of Corticosterone in the Adrenocortical Secretion of Premature Infants , J. Lab. & Clin. Med. 43:831 ( (June) ) 1954. 17. Eagle, J. F.: Discussion , in Adrenal Function in Infants and Children: A Symposium , edited by L. I. Gardner, New York, Grune & Stratton, Inc., 1956, pp. 41-44. 18. Ulstrom, R. A., and Doeden, D.: Chromatographic Studies of Urinary Steroids in Term and Premature Infants , in Adrenal Function in Infants and Children: A Symposium , edited by L. I. Gardner, New York, Grune & Stratton, Inc., 1956, pp. 31-40. 19. Thornton, M.; Hughes, E. R.; Ely, R. S., and Kelley, V. C.: The Changing Pattern of Adrenal Corticosteroids from Birth to Maturity, read before the Society for Pediatric Research, Quebec, Canada, June 15, 1955. 20. Harris, G. W.: Neural Control of the Pituitary Gland , Physiol. Rev. 28:139 ( (April) ) 1948. 21. Harris, G. W.: Neural Control of the Pituitary Gland: II. The Adenohypophysis , Brit. M. J. 2:627 ( (Sept. 15) ) 1951. 22. Symington, T.; Currie, A. R.; Curran, R. C., and Davidson, J. N.: The Reaction of the Adrenal Cortex in Conditions of Stress , in Ciba Foundation Colloquia on Endocrinology , Vol. 8, edited by G. E. W. Wolstenholme and M. P. Cameron, Boston, Little, Brown & Company, 1955. 23. Sayers, G., and Sayers, M. A.: The Pituitary-Adrenal System , in Recent Progress in Hormone Research , Vol. 2, edited by G. Pincus, New York, Academic Press, Inc., 1948, p. 81. 24. Hume, D. M., and Wittenstein, G. J.: The Relation of the Hypothalamus to Pituitary-Adrenocortical Function , in Proceedings of the First Clinical ACTH Conference , edited by J. R. Mote, Philadelphia, The Blakiston Company, 1950, p. 134. 25. Graham, B. F., and Cleghorn, R. A.: Changes in the Circulating Leukocytes Following Electrically-Induced Convulsions in Man , J. Clin. Endocrinol. 11:1469 ( (Dec.) ) 1951. 26. Rosvold, H. E.; Kaplan, S. J., and Stevenson, J. A. F.: Effects of Electro-Convulsive Shock on Adrenal Cortex of the Rat , Proc. Soc. Exper. Biol. & Med. 80:60 ( (May) ) 1952. 27. Sayers, G., and Burke, R.: Blood ACTH During Ether Anesthesia , Fed. Proc. 14:131 ( (March) ) 1955. 28. Egdahl, R. H.; Nelson, D. H., and Hume, D. M.: Effect of Hypothermia on 17-Hydroxycorticosteroid Secretion in Adrenal Venous Blood in the Dog , Science 121:506 ( (April 8) ) 1955. 29. Eik-Nes, K.: Adrenocortical Activity and Metabolism of 17-Hydroxycorticosteroids in Anesthetized Dogs Exposed to Cold , Fed. Proc. 14:336 ( (March) ) 1955.

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A.M.A. Journal of Diseases of Children – American Medical Association

Published: Dec 1, 1958

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