[17-ketosteroid sulfates and its application to kampo-medicine].

Traditional oriental medicine tells us that everything is interrelated and consists of combinations of opposing factors, "Yin-Yang". So we need to evaluate the normal state and pathologic condition from the perspective of dynamic hormone balance between cortisol and DHEA which are opposing and physiologically very important. Cortisol has a more functional side and is considered Yang, while DHEA has a more material side and is considered Yin. We tried to explain the concepts of KAMPO which include SHO (Yin-Yang. Excess-Deficiency), the 6 Stages of Disease and Deficiency of the Kidney, by measuring urinary 17-OHCS and 17-KS-S, metabolites of cortisol and DHEA. We think our effort may develop a good objective indicator of KAMPO's diagnosis and be useful for selecting of treatment.

[Stress and adaptation in humans--aging, illness, psychosocial stress].

We conducted research to determine compounds in human urine which show high values in healthy individuals, decrease with failing health (or bodily decay), clearly decline with advancing illness and finally reach very low values during terminal and severe illness. We have initially established that 17-ketosteroid sulfates (17-KS-S) are the substances we were searching for. Hans Selye regarded stress as the rate of wear and tear and 17-OHCS (cortisol) as its indicator. He further considered that stress is distinct from aging: There is no difference in the stress of ordinary life between young and old people, and there is no difference in 17-OHCS levels between the two. Aging is, however, accompanied by decreased adaptability. In terms of adaptability, we consider that, different from inanimate objects, energy transforming live organisms exist in a dynamic balance between "wear and tear" and "repair and recovery". This shows the need to determine the organism's adaptability to at least these two factors. We regarded 17-OHCS as a compound related to tissue "wear and tear" and searched for a compound related to tissue "repair and recovery", leading us to an identification of 17-KS-S. In other words, we have been considering the relation between "repair and recovery" and "wear and tear". The measurement of 17-KS-S which decreases with failing health, when combined with 17-OHCS, may make it possible to evaluate distortion of adaptation in a Yin-Yang like fashion, which can demonstrate the presence of illness, susceptibility to illness and progress of disease in individuals. It further adds a new dimension to clinical diagnostic acumen in an objective evaluation of psychosocial stress where results of routine clinical tests are often within normal limits, thus facilitating the monitoring of health and illness.

[Considerations in clinical testing--implications of urinary 17-ketosteroid sulfate and 17-hydroxycorticosteroid measurements for stress research].

With the recent increase in number of patients with stress, the search is continuing for health-indicators that can be used to determine stress reliably and quickly. These indicators rely on subjective evaluations, and the establishment of an objective method of determining stress is necessary. We have developed a method involving the determination of the 17-Ketosteroid sulfates (17-KS-S) which has proved valuable for stress research. By simultaneous measurement of both 17-KS-S and 17-hydroxycorticosteroids (17-OHCS), which have different biological significance, and which originate from the adrenal gland, an organic Yin-Yang evaluation of the adrenocortical function can be made. The two values (mainly the 17-KS-S values) are closely correlated to the biological stress state as evaluated from psychosocial factors. This method should prove to be valuable in the clinic as an objective method of determining stress.

[Primary care considerations--17-ketosteroid sulfate-17-hydroxycorticosteroid method as a clinical stress indicator].

In primary care, the management of stress-related diseases occupies a wide spectrum of prevention and treatment, from holistic health care to final cure, centered on medical health and an organic integration of body, mind, and social parameters. Inquiries are being made at examinations and interviews to obtain information on the health condition of the patient, but, they are inadequate. There is a need for an objective indicator to help in the diagnosis. With the introduction of the Stress Barometer (measurements of 17-ketosteroid sulfates and 17-hydroxy-corticosteroids) it has become possible to obtain critical information on a patient in a very short time. This method allows early detection of stress, depression state and tiredness from work which is not presently possible from blood tests. It then becomes possible to call the patient's attention to these matters and to work at increasing awareness, energy levels, and responses to the conditions that are determined in this manner.