A panel of leading experts integrate the latest findings from basic and clinical science to create a comprehensive treatment of the processes by which the brain acts as an endocrine organ, not only to control hormonal functions, but also to maintain homeostasis and regulate behavior. The authors-recognized both as leaders in their fields and as skilled teachers-provide systematic coverage of the analytical, anatomical, functional, clinical, and pathological aspects of neuroendocrinology. Topics range from the interactions between the nervous and endocrine systems to the regulation of reproduction, development, metabolism, fluid balance, and biological rhythms. Neuroendocrinology in Physiology and Medicine offers an unprecedented marriage of clinical and basic knowledge that has been missing from classical neuroscience, endocrinology, and physiology texts. It will teach today's medical students and serve researchers as a valuable reference to this rapidly growing field.

In the past five years, so much additional progress has been made in ourunderstanding of both the basic and c1inical aspects of a wide variety of thyroid disorders that a second edition of Diseases of the Thyroid was considered a necessary addition to the Contem porary Endocrinology series. Fresh perspectives also seemed warranted, so we recruited new authors for many of the chapters and believe that this edition will provide the reader with further insights into the pathophysiology and c1inical presentation and treatment of thyroid disease. It inc1udes topics ranging from neonatal thyroid screening, thyroid dysfunction during infancy and childhood, peripartum thyroid disorders, thyroid disease in the elderly, and the c1inical relevance of the sodiurnliodide symporter (NIS) to the pathogenesis and treatment of nodular goiter, thyroid cancer, thyrotoxicosis, and hypothyroidism. The worldwide problem of iodine deficiency and its eradication is also discussed, along with environmental goitrogens and iodine-induced thyroid disease. I am indebted to all the contributors for their cooperation and expertise in providing their chapters in an extremely timely fashion, to Mr. Thomas Moore and Mr. Craig Adams from Humana Press for their expert assistance, and to Ms. Christine Archung for providing superb administrative assistance. Lewis E. Braverman, MD v CONTENTS Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Molecular Mechanisms of Nuclear Thyroid Hormone Action William W. Chin and Paul M. Yen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Nongenomic Actions of Thyroid Hormone Paul 1. Davis and F aith B. Davis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 3 Thyroid Testing: A Clinical Approach Laurie A. Kane and Hossein Gharib . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."

This volume includes the latest diagnostic criteria for PCOS and comprises the most up-to-date information about the genetic features and pathogenesis of PCOS. It critically reviews the methodological approaches and the evidence for various PCOS susceptibility genes. The book also discusses additional familial phenotypes of PCOS and their potential genetic basis. All four editors of this title are extremely prominent in the field of PCOS.

Diabetes affects an estimated 20 million people in the United States, with many people remaining unaware that they suffer from the disease. While the number of diabetics continues to rise, the number of caregivers who specialize in diabetes treatment does not. In Educating Your Patient with Diabetes, Katie Weinger and Catherine Carver assemble commentary from a panel of leading diabetes practitioners and researchers and put together a highly readable guide to supplying patients with diabetes with the information and ability to successfully cope with their disease. The authors and editors provide substantive data on successful models of diabetes education and the process of educating diabetes sufferers. Additional chapters discuss diabetes in pregnancy, the challenge of weight and diabetes management in clinical practice, and diabetes education in geriatric populations. Timely and accessible, Educating Your Patient with Diabetes is a must have for all diabetes educators, physician assistants, nurses, and endocrinologists who endeavor to support their patients' diabetes self-care efforts and help them maximize the opportunities for patient learning.

During the past five to ten years, a variety of tools has been developed in the disciplines of both gene engineering, and molecular and structural biology. Some of these advances have permitted scientists not only to identify and characterize genes, but also to target these genes by disruption, thus eliminating their function in living animals, and to det- mine the biological responses to altered gene products. This has particular significance in endocrine systems, in which feedback mechanisms between the hypothalamus, pi- itary, and end organs are critical in normal physiology. Interpretation of the physiological significance, or the site of action of specific molecules in this context, has been difficult prior to transgenic technology. Major advances have occurred specifically in the areas of growth and development, and of reproduction. Coupled with analysis of naturally occurring mutations in humans, the use of transgenic animals and in vitro systems has recently allowed endocrinologists to understand the importance of specific thyroid hormone receptor isoforms in vivo, the molecular basis for generalized resistance to thyroid hormones via mutations in the nuclear receptor, and mechanisms for suppressing gene transcription. Previously designated "orphan rec- tors," such as steroidogenic factor-1, were demonstrated to have critical roles in dev- opment and reproduction. Other nuclear receptors-including those for thyroid hormone, estrogens, androgens, and progesterone-were shown to bind to coactivator and co- pressor proteins that modified their transcriptional activity, and contributed to the ce- specific effects of the hormones.

Distinguished clinician-scientists describe in concise studies their most difficult cases and reveal what they did, how they did it, and why. The cases cover a wide range of endocrine problems. Each case study reviews how the patient was managed, details the reasons why various tests and treatments-many only recently available-were carried out, and provides references to ensure that those novel methodologies can be easily translated into the endocrine specialist's daily practice. The authors provide practical solutions for these difficult-to-manage cases, and successfully apply knowledge fresh from the laboratory to decisions about patient management. Practical and stimulating, Challenging Cases in Endocrinology demonstrates for every clinical endocrinologist precisely how specialists approach their most challenging cases and how these approaches can be effectively applied in the daily practice of endocrinology.

RNA binding proteins are an exciting area of research in gene regulation. A multitude of RNA-protein interactions are used to regulate gene expression including pre-mRNA splicing, polyadenylation, editing, transport, cytoplasmic targeting, translation and mRNA turnover. In addition to these post-transcriptional processes, RNA-protein interactions play a key role in transcription as illustrated by the life cycle of retroviruses. Unlike DNA, the structure of RNA is highly variable and conformationally flexible, thus creating a number of unique binding sites and the potential for complex regulation by RNA binding proteins. Although there is a wide range of topics included in this volume, general themes have been repeated, highlighting the overall integrative nature of RNA binding proteins. The chapters have been separated into three different sections: Translational Control; mRNA Metabolism; and Hormonal and Homeostatic Regulation. The chapters of this volume were written with the seasoned investigator and student in mind. Summaries of key concepts are reviewed within each chapter as well as guiding questions that can be used to stimulate class discussions. The Editors of this volume hope that this compendium educates, enthralls, and stimulates the readers to look to the future possibilities in this rapidly evolving field.

The explosive growth in the field of molecular biology over the last two decades has started to make a great impact on clinical medicine. Genes have been cloned for diseases that were poorly understood only a decade ago. Additionally, investigators are increasingly aware that there are strong genetic components to complex disorders, such as osteoporosis, that are not classically thought of as genetic disorders. New insights into the pathogenesis of metabolic bone diseases have been obtained from investigations into the molecular biology of these diseases and new therapies will become available based on these new insights. In The Genefies of Osteoporosis and Metabolie Bane Disease, I have assembled an internationally renowned group of experts to write the various chapters. Each of the authors is an expert in his/her field who is currently performing research on the content of their chapter and have made important contributions to the understanding of the clinical fea tures and pathophysiology of metabolic bone disease and genetics. The first part of The Genefies of Osteoporosis and Metabolie Bane Disease addresses issues related to genetic contributions to the development of osteoporosis and the many factors that must be considered when searching for genesthat predispose to osteoporosis. The second sec tion addresses recent advances in the clinical and molecular biological aspects of inherited metabolic bone disorders. The last section reviews the latest techniques for finding genes that predispose to metabolic bone diseases.

Authoritative researchers and clinicians review our latest understanding of andrology in both basic science and clinical medicine. Topics range from explaining the biology of androgens-from several different perspectives-to illuminating their role in the development and modulation of physiologic systems. Authors demonstrate in a number of cases that testosterone can be a useful adjunct to the treatment of a variety of disease states. Other chapters consider important topics such as androgens use in athletes, the potential of androgens to improve physical function and quality of life in older men, and androgens as potential male contraceptives.

It has been over 40 years since the original report by Salmon and Daughaday demon strating that the ability of GH to stimulate sulfation of cartilage was mediated by a "sulfation factor. " In the ensuing decades, it has become apparent that this "sulfation factor activity" encompasses a complex system ofligands (IGFs), receptors, and carrier proteins that are, in tum, responsible for a wide array of cellular actions. The IGF system has been demonstrated to be critically involved in both intrauterine and postnatal growth, and to have important implications in cancer biology as well, owing to the ability of the IGFs to function in endocrine, paracrine, and autocrine modes and given the wide distri bution of IGFs in virtually every organ system. The contributions to The /GF System reflect the wide span of interest in the IGF system and its implications for normal and abnormal growth and metabolism. The chapters have been divided into four broad sections: I. Molecular biology of the IGF system; II. Bio logical actions of the IGFs; III. IGF physiology; and IV. Clinical aspects of the IGFs. We have made every effort to highlight the major contemporary themes in IGF biology, but as is inevitable in such a fast-moving field, perspectives will continue to change as new information is accumulated."

Gerald Reaven, the discoverer of Syndrome X, and a panel of world-class investigators thoughtfully summarize our current understanding of how insulin resistance and its compensating hyperinsulinemia play a major role in the pathogenesis and clinical course of high blood pressure and cardiovascular disease-the so-called diseases of Western civilization. These distinguished authorities detail, for the first time, the pathophysiological consequences and the clinical syndromes, excluding Type 2 diabetes, related to insulin resistance. They also examine the genetic and lifestyle factors that contribute to the wide differences in insulin action that exist in the population at large. Timely and authoritative, Insulin Resistance: The Metabolic Syndrome X illuminates the full importance of insulin resistance as a major cause of hypertension, heart disease, and polycystic ovary syndrome.

Don P. Wolf and Mary Zelinski-Wooten provide a comprehensive review of the procedures and techniques used in assisted reproduction, as well as in nuclear transfer for both the treatment of human infertility and the propagation of animals. Combining the details of clinical application with the physiological facts of reproduction, the authors treat subjects such as the in vitro maturation of oocytes, embryo culture, intracytoplasmic sperm injection, and the process of nuclear transfer. Cutting-edge and wide-ranging, Assisted Fertilization and Nuclear Transfer in Mammals offers clinical ARTs practitioners, research scientists, those responsible for animal care, and students not only an informative historical perspective on the development of ARTs, but also updates on several of the more dynamic clinical areas, and a highly practical understanding of their applications.

Leading researchers and experienced clinicians join forces not only to illuminate today's understanding of the endocrinology of menopause, but also to provide a sound basis for its successful management. These seasoned experts review in detail the cardiovascular, bone, brain, and genitourinary changes that accompany menopause and spell out the risks, benefits, and alternatives of conventional hormone replacement therapy. Selective estrogen receptor modulators (SERMs), androgen replacement, calcium supplementation, and the role of phytoestrogens are also fully reviewed. Menopause: Endocrinology and Management offers practicing physicians a comprehensive understanding of the menopause process, as well as an evidence-based approach to optimizing treatment strategies for the challenging medical problems accompanying this important period in women's lives.

Diabetes mellitus is the collective name for a group of diseases associated with hyperglycemia (high levels of blood glucose) caused by defects in insulin p- duction, insulin action, or both. About 6. 2% of the US population (17 million people) have diabetes mellitus. It is the leading cause of kidney failure, bli- ness, and amputations. It is also a major risk factor for heart diseases, stroke, and birth defects. Diabetes Mellitus: Methods and Protocols provides a state-of-the-art account of the experimental methodology for studying the molecular defects leading to diabetes mellitus, both at the molecular and biochemical levels. The chapters cover a wide range of topics written by experts in their respective fields and are organized in two sections: Insulin Production and Insulin Action. The detailed experimental protocols presented, including the notes of interest, provide a very useful tool for basic researchers and clinicians for investigating and treating this disease. Each chapter starts with an introduction to a specific technique and explains its application in the field of diabetes research. Following the list of materials, a detailed description of the technique is presented in the methods section in a way that enables the successful execution of the protocol. The "Notes" section at the end discusses the pitfalls of the technique and alternative approaches. I am grateful to the numerous scientists who have contributed to this volume by writing both highly detailed and understandable chapters.

The aim of this book is to inform clinicians of recent advances in obesity research and provide a review of current treatment issues and strategies. Part 1 covers new discoveries in the physiological control of body weight, as well as the pathophysiology of obesity. Part 2 covers a range of issues that are central to the clinical management of obese patients. This illustrated volume will stimulate and engage clinicians.

An unprecedented compilation of state-of-the-art advances in clinical research by premier clinical scientists around the world. This volume discusses the methods of clinical research and the interpretation of their results in studies of normal individuals, obese subjects, and patients with diabetes mellitus. Along the way, the authoritative contributors writing here illuminate how changes in the hormone action and substrate metabolism of healthy humans may lead to obesity and noninsulin-dependent diabetes mellitus.

This book covers the most important clinical and bench science aspects of metabolic syndrome. It will be of value to all of those seeking a comprehensive update on the metabolic syndrome. Furthermore, it will provide a broad basis for advancing research in the multiple intersecting disciplines encompassed by the metabolic syndrome.

During the past several decades, much research effort has gone into the elucidation of the role of neuroendocrine systems as secretory and metabolic regulators of cells of a variety of organs and structures, including the testes, ovaries, adrenals, thyroid, pituitary gland, and mammary glands. However, the role of cells comprising such organs and structures in the modulation of neuroendocrine processes has received considerably less is generally less well appreciated. attention and Nonetheless, it is important that we understand the actions on neuroendocrine systems of substances that reach the brain by way of the vasculature, including hormones, cytokines, toxins, amino acids, drugs, and similar agents. In order to analyze the present state of knowledge on this topic, experimental scientists and clinicians, whose shared interests include actions of circulating agents on the brain, met at a satellite symposium of the XXXI International Congress of Physiological Sciences. This symposium, entitled Circulating Regulatory Factors and Neuroendocrine Function, was held in Smolenice Castle, Czechoslovakia, June 26-July 1, 1989, and reviews delivered at this symposium as invited presentations are published in this volume. Presentations given as free communications have been published separately and are available in Endocrinologia Experimentalis 24: 1-273, 1990.

Diabetes is a huge and growing healthcare worry, especially in Western countries. The treatment of both types - 1 and 2 - of this disease has changed radically over the past few years. This work provides an overview of all the changes that will come to be implemented in clinical practice. Summarizing all aspects of treatment, this book delineates the large amount of research work that has been completed over the last few years into the relief of complications in diabetes and vascular medicine in general.

This book is an edited collection of the literature on leptin beginning with the discovery of leptin and a study of its affect on animals and in humans. Chapters will focus on the discovery, history, roles and regulation of leptin in all the major areas of physiology, as well as on assay methods, phylogeny and genetics. The timing of this volume is long overdue and is the first comprehensive coverage of leptin physiology in the field.

- This series is indexed in index Medicus

- The turn around time for this series is fast, making the research as accurate as a journal

Paget's disease is an old disease historically, but a new disease therapeutic ally. Human remains unearthed in Lancashire, England, dating from ap proximately 900 AD, show clear evidence of the aftliction. However, it was not until the 1800s that physicians rediscovered the condition, and a little more than 100 years ago that Sir James Paget published a perceptive and accurate description of the disease from the clinical and pathologic points of view. He felt the disease represented an inflammatory condition of the skeleton and hence named it osteitis deformans. The condition again lapsed into anonymity for several decades afterwards, and therapeutic approaches did not evolve until after World War II when several groups, located mainly in the Boston area, began using a variety of agents, includ ing corticosteroids for treatment of this condition. These early attempts at therapy were unsuccessful and the condition remained essentially untreat able until the development of the calcitonins and the bisphosphonates in the 1970s. In 1978, the Paget's Disease Foundation, a private nonprofit volun tary health agency, was founded to assist individuals aftlicted by Paget's disease of bone, to provide education regarding this condition to the medical community, and to encourage research efforts to better under stand and treat the condition. An international conference was organized under the aegis of the Paget's Disease Foundation and was held in New York City in October, 1989, ten years after the founding of the Paget's Disease Foundation."

Recent advances in non-invasive sampling techniques have led to an increase in the study of hormones and behaviour. Behaviour is complex but can be explained to a large degree by interactions between various psychological and physiological components, such as the interplay between hormonal and psychological systems. This new textbook from Nick Neave offers a detailed introduction to the fascinating science of behavioural endocrinology from a psychological perspective, examining the relationships between hormones and behaviour in both humans and animals. Neave explains the endocrine system and the ways in which hormones can influence brain structure and function, and presents a series of examples to demonstrate how hormones can influence specific behaviours, including sexual determination and differentiation, neurological differentiation, parental behaviours, aggressive behaviours and cognition. This introductory textbook will appeal to second and third year social science undergraduate students in psychology and biomedicine.

Recent advances in non-invasive sampling techniques have led to an increase in the study of hormones and behaviour. Behaviour is complex but can be explained to a large degree by interactions between various psychological and physiological components, such as the interplay between hormonal and psychological systems. This new textbook from Nick Neave offers a detailed introduction to the fascinating science of behavioural endocrinology from a psychological perspective, examining the relationships between hormones and behaviour in both humans and animals. Neave explains the endocrine system and the ways in which hormones can influence brain structure and function, and presents a series of examples to demonstrate how hormones can influence specific behaviours, including sexual determination and differentiation, neurological differentiation, parental behaviours, aggressive behaviours and cognition. This introductory textbook will appeal to second and third year social science undergraduate students in psychology and biomedicine.

Biomedical devices that contact with blood or tissue represent a wide range of products. Depending on their potential harm to a body, medical devices are categorized according to the degree, so their safety can be assured. All biomaterials are by definition designed to contact with a body for a certain period of time. The nature of the body contact, as well as the duration a material contacts with the body may initiate unwanted biological In comparison with invasive devices Oike catheters and medical responses. implants contact directly with tissue or with the circulating blood) non invasive devices (like wound-dressings and contact lenses contact with the skin, the sclera, and the mucosa or with open wounds) have a lesser risk of hurting a patient. When blood contacts with a foreign material, plasma proteins become absorpted to the surface within a few seconds. The reactions that follow, the so-called intrinsic pathway lead to the formation of fibrin and activation of platelets and white blood cells, result in blood clot formation."