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S. L. JEFFCOATE
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R. V. BROOKS
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D. R. LONDON
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P. M. SMITH
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G. S. SPATHIS
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F. T. G. PRUNTY
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SUMMARY

C19-steroids, testosterone and oestrogen production rates have been measured simultaneously by urinary isotope dilution in a group of 18 patients with polycystic ovaries and in two normal women.

The production of total C19-steroids remained high in seven patients under dexamethasone suppression, suggesting a major ovarian contribution. In eight it did not remain high, suggesting a major adrenal contribution.

The rate of testosterone production was usually normal under dexamethasone. The rate of oestrogen production was not subnormal and even occasionally raised.

Ovarian wedge resection produced a good clinical response in 75% of the observations, and C19-steroid production fell. The latter was not so evident if there was no clinical response. Testosterone production was usually reduced. Oestrogen production rate changed irregularly.

Administration of human pituitary follicle-stimulating hormone caused a concurrent increase in C19-steroids, testosterone and oestrogen production in four out of five patients.

The inadequacy of the urinary isotope dilution technique, in attempting to measure testosterone secretion and interconversion of testosterone and androstenedione in these patients, has been stressed and discussed.

Some correlations have been established with direct observations on ovarian steroid metabolism in certain patients reported elsewhere.

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S. L. JEFFCOATE
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R. V. BROOKS
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N. Y. LIM
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D. R. LONDON
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F. T. G. PRUNTY
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G. S. SPATHIS
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SUMMARY

1. Various parameters of androgen metabolism have been studied in a group of 11 hypogonadal men. They included the rates of: 17-oxosteroid excretion, total production of C-19 steroids, secretion of testosterone and total production of testosterone (including testosterone converted peripherally from other steroids). The concentrations of testosterone and androstenedione were also measured in peripheral and testicular venous plasma. In addition the effects of stimulation and suppression of adrenocortical function and of testicular stimulation were studied.

2. The patients were divided into three groups according to clinical features, gonadotrophin excretion and testicular histology and an attempt was made to correlate these tests with the steroid studies.

3. Patients with poorly developed secondary sexual characteristics had a low testicular secretion of testosterone. There was also an indication that in these cases the adrenal gland contributed significantly to the plasma testosterone.

4. Methods involving estimations of androgens in blood are shown to be of more value than estimations in urine. In some instances anomalous results were obtained for the rates of secretion of testosterone. The possible significance of these anomalies is discussed.

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