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Free polar corticosteroids (FPCS) excretion in the urine of normal children and adults and those with leukemia and other neoplastic diseases was measured by a quantitative procedure previously developed for similar studies in the guinea pig. In man, by use of ethyl acetate extraction of neutral urine, 5 blue tetrazolium reducing zones are detectable after chromatography in the chloroform formamide system, zone I being the most polar (slowest moving) and containing 6-β-hydroxycortisol as a major component. Zones were eluted with methanol and measured quantitatively by the Porter-Silber method. Total FPCS in normal adults (321 to 460 μg per day) were greater than the total FPCS in normal children (105 to 138 μg per day). All zones contributed to the threefold increase noted. In normal pregnancy studied at weekly intervals, base-line values (375 μg per day) increased during pregnancy, ranging from 375 to 500 μg per day in the first trimester, 400 to 800 μg per day in the second trimester, and 700 to 1200 μg per day in the third trimester, returning toward base-line values after delivery. Increases occurred through elevation of the more polar zones. In patients with leukemia studied before, during, and after the day of ACTH administration, there was a rise in total FPCS after ACTH, with the increases in zone I (major component, 6-β-hydroxycortisol) reflecting the response to ACTH and accounting for over 40 per cent of the FPCS. The FPCS rise after ACTH was 129 and 97 per cent over base-line values in both children and adults with leukemia, respectively. In patients with other neoplastic diseases examined before, during, and after the day of ACTH administration or surgical therapy, a similar responsiveness was noted. Corresponding increases in conjugated corticosteroids were noted whenever measured in conjunction with FPCS measurements.
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Accepted: September 5, 1963
Received: September 27, 1962
☆A preliminary report appeared as part of an abstract in Clin. Res. Proc. 4: 35 1956, and was presented at the January 1956, meeting of the American Federation of Clinical Research in New Orleans.
© 1964 Published by Elsevier Inc.