Help-seeking among Asian and Pacific Americans: a multiperspective analysis.

The attitudes of Asian Americans and Pacific Islanders toward mental health and help-seeking at least partly account for rates of underutilization of formal mental health services. This article explores cultural themes and concepts associated with service utilization to better understand patterns and trends in help-seeking by these groups. A multilevel framework based on traditional behavioral and cognitive styles helps explain patterns of help-seeking in a Western context. An analysis of the norms and values governing Asian and Pacific Islander behaviors reveals numerous implications of sensitive and effective treatment.

Adrenal steroids in serum during danazol therapy, taking into account cross-reactions between danazol metabolites and serum androgens.

To investigate the changes in the serum androgen concentrations and the Free Androgen Index (FAI) in women during danazol therapy, we measured the serum concentrations of adrenal steroids and danazol metabolites, and then examined the effects of danazol metabolites on assays for serum androgens. Thirteen women who had endometriosis were treated with danazol (300 or 400 mg/day) for 8 to 16 weeks. Blood samples were taken before, during, and after the medication. During the danazol therapy, serum testosterone (T), cortisol (F), and sex-hormone binding globulin (SHBG) significantly decreased (P < 0.05); but serum dehydroepiandrosterone-sulfate (DHEAS) and FAI increased (P < 0.05). The serum concentrations of danazol metabolites were: danazol, 209.0 +/- 28.3 (ng/mL, mean +/- SEM); delta 1-2-hydroxymethyl ethisterone, 114.4 +/- 8.4; and 2-hydroxymethyl ethisterone, 660.0 +/- 54.2. There was considerable cross-reaction between danazol metabolites and androgens [T, androstenedione (A), and dehydroepiandrosterone (DHEA)] in the direct assays. As for the ratios of adrenal steroids in serum, the DHEAS/F, DHEAS/DHEA, and 11-deoxycortisol (S)/F ratios increased (P < 0.05). We conclude that the increase in FAI and DHEAS represents increased native androgenic activity with danazol, and the changes in adrenal steroid ratios in serum indicate the inhibition of 11 beta-hydroxylase and sulfatase activities during danazol therapy.

Levels of androgens and danazol metabolites in serum during danazol therapy.

Thirteen women who had endometriosis were treated with danazol (300 to 400 mg/d). Levels of androgens and danazol metabolites in serum and the influences of danazol metabolites on the assays for serum androgen were investigated during danazol therapy. Serum DHEAS significantly increased (P < 0.05), but serum DHEA slightly decreased. Serum T levels, measured by direct assay, were markedly elevated. However, measured after HPLC separation, the T levels in serum were significantly decreased (P < 0.05). There were considerable cross-reactions between danazol metabolites and androgens (T, DHEA, and A) in RIA. Purification of androgens using column chromatography was necessary to measure serum androgens precisely.

Changes of serum concentrations of dehydroepiandrosterone, its sulfate, 11-deoxy-17-ketosteroids, cortisol, estradiol, testosterone, prolactin and gonadotropins in normal prepubertal and pubertal females.

The concentrations of serum dehydroepiandrosterone (DHA), DHA sulfate (DHA-S), 11-deoxy-17-ketosteroids (11-deoxy-17-KS), cortisol (F), estradiol (E2), testosterone (T), prolactin (PRL), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were measured by means of radioimmunoassays in 157 prepubertal and pubertal girls whose age ranged from 5 to 16. Among the hormones studied, DHA exhibited a first significant increment at age 8, ahead of all other hormones. The significant increases of 11-deoxy-17-KS and DHA-S occurred at age 9 and 10, respectively. After the occurrence of the significant increment, the concentrations of these androgens increased progressively with age. DHA/DHA-S ratio showed a decreasing trend with the advance of age. F did not show any significant variation with age. E2 increased significantly at age 11 and T at age 10. PRL increased significantly at age 12 but its concentration did not seem to vary very much with age after 9. FSH and LH started to increase after age 9, with their significant increases occurring at age 10 and 9, respectively. These results confirm that during the course of pubertal development in girls, adrenal androgens increase first, which is followed by pituitary gonadotropins and then gonadal estrogen.