[Pituitary-adrenocortical response to surgical stress in male patients]

Effects of major surgical stress on the plasma levels of twelve kinds of steroid hormones, ACTH and renin activity, and on the excretion rates of urinary free cortisol and acid labile aldosterone etc. were studied in eleven male patients for seven days following operation. In another groups of patients, ACTH tests were carried out in order to investigate the effect of ACTH on the adrenal steroid hormone production. Also, an in vitro assay of the effect of ACTH on the adrenal tissue was performed. Surgical stress provoked marked increase in plasma levels of cortisol, despite little change in aldosterone levels. The postoperative plasma testosterone concentration showed a profound decrease throughout the observation period. The plasma renin activity reached the highest level on the first postoperative day, when plasma aldosterone was at the lowest level. It was concluded that the postoperative changes in the plasma steroid hormone levels were markedly influenced by other physical and humoral disorders provoked with surgical stress.