Gastroparesis is an increasingly recognized disorder. Treatment can be difficult due to the several mechanisms for symptom production. Gastroparesis: Pathophysiology, Presentation and Treatment serves as a concise reference on this disorder that allows clinicians to quickly access and evaluate the necessary information for treating and managing patients with gastroparesis. Each chapter is written byexperts in their respective area. The volume will enable the reader to better understand all aspects of this disorder. The book presents current concepts in a variety of areas opening with the epidemiology, clinical presentation and pathophysiology of gastroparesis. The natural history of patients is explored as well as evaluation of patients with suspected gastroparesis. This section includes chapters on Wireless Capsule Motility, Electrogastrography and Antroduodenal Manometry. This important resource concludes with a full section on treatment including dietary, prokinetic, antiemetic, sensory, electric stimulation, and surgical methods. New developments include the use of gastric electric stimulation for treatment, the use of SmartPill for diagnosis, and a number of new agents in development for this disorder. Gastroparesis: Pathophysiology, Presentation and Treatment is the ideal reference for gastroenterologists, and also for surgeons, endocrinologists, primary care physicians and nutritionists looking to keep pace with the latest information treatment options for their patients. "

A number of chapters present the most novel research on testicular and epididymal functions or on more general fields of hormone action and molecular cell biology as it is now a tradition. However, exceptionally, the book also contains several chapters dealing with the "Approaches and Tools in the Third Millenium." The unusual inclusion of technologies as such in the 2000 edition of the workshop was an absolute necessity, as these technologies are revolutionizing the fields of biology and medicine and, in many instances, how to do research. This volume gives the scientific community essential information about the very latest technical developments and their potential for future progress.

Readers of this book can update their knowledge in the fast-moving field of endocrinology and neurobiology. Topics concerning growth and development are extensively reviewed from both basic science and clinical viewpoints. Aspects related to growth development and to the control of cellular differentiation and multiplication are discussed. Further new information is provided on: synthetic recombinant human growth hormone (rHGH); potential diagnostic and therapeutic applications of the neuropeptide, growth hormone releasing hormone (GHRH); the physiology and physiopathology of the neural control of growth hormone secretion; the diagnosis and therapy of growth hormone deficiency or excess states; and the biology, function and possible utilization of growth factors. These important new findings are relevant to progress in pediatrics, pediatric and clinical endocrinology, neuroendocrinology and physiology.

The rapid developments in molecular genetics have clarified many of the muta tions in monogenic thyroid diseases over the last two decades; now the target of molecular thyroid genetics has become the oligogenic thyroid diseases. These include the autoimmune thyroid diseases and familial thyroid cancers, both of which are much commoner than the monogenic diseases. However, the method ological approach to the genetics of these more complex diseases is still far from being well established. Although the discovery of susceptibility genes has been partially accomplished in complex diseases such as asthma, Crohn's dis ease, and types I and II diabetes mellitus, the elucidation of susceptibility genes in complex diseases remains a major challenge. This volume contains papers presented at the International Symposium on the Genetics of Complex Thyroid Diseases. This meeting was held in association with the International Thyroid Congress in Kyoto in October 2000 and sup ported in part by the Japan Intractable Diseases Research Foundation and Knoll Pharmaceuticals Inc. The symposium was the first international symposium con cerning the genetics of complex thyroid diseases and was restricted to the study of the autoimmune thyroid diseases and familial thyroid cancer. Twenty distin guished researchers from the United States, the United Kingdom, France, Ger many, Italy, and Japan were invited. Each presentation precipitated intense dis cussion and there was much consensus during the meeting. Nevertheless, this volume will leave the reader with a clear understanding of how little we still know.

Designed for easy revision of the key points, key references, and key management stages, the two volumes in this set review the evidence for best practice, presenting the reader with the right information, in the right format, summarized in easy-to-use tables and algorithms. Each guideline is designed to "make it easy to do it right", with appropriate use of proven interventions. The quality of evidence available is graded so that a well-informed clinician can improve the health of mother and baby by providing quality care. *Offers an easy-to-assimilate guide to the key points in maternal-fetal and obstetric practice *Supplies an invaluable resource for those revising topics for professional or clinical requirements *Ensures providers of care can locate the best intervention quickly and confidently

This book provides a concise summary across all aspects of endocrine surgery, covering the major endocrine organs and discussing aspects of surgical care. It comprises five sections covering the major endocrine organs/systems, each with a specialist section editor. Within each section there are a number of brief (2-3 page) chapters, written in a combination of prose and bullet points, a format that is conducive to both detailed reading and quicker, "dipping in", review. Each chapter contains a "Pearls and Pitfalls" summary box. The text takes into account the latest evidence and current expert opinion from an internationally renowned list of authors.

Sex matters! Are there differences between the sexes when it comes to brain function and the behaviours that result? This volume attempts to answer this fundamental question. If the answer is 'yes' then this should impact upon our approach to treating mental illness in humans, and to modelling it in animals, as we look for aetiological and pharmacological solutions.

In mammals, a robust physiologic system acts to maintain relative constancy of weight. A key element of this system is leptin. The nature of this "brain-somatic" cross talk is as yet poorly understood, but it is likely to have important implications for the pathophysiology and treatment of obesity, diabetes and other metabolic disorders.

Professor Egon Diczfalusy, a pioneer in gynaecological endocrinology and in particular female contraception, celebrated his 80th birthday with a scientific symposium. The participants were scientists from all over the world who had been scholars and close collaborators at different points in time. The interdisciplinary meeting consisted of lectures on the epidemiological impacts of ageing, its challenge for the pharmaceutical industry, philosophical aspects of the future of mankind, and the history and future of contraception. Three round table discussions addressed the hormonal control of reproduction and ageing, new approaches and future perspectives of contraception for women and men, and hormone replacement in the elderly.

This volume contains the proceedings of the third in a series of conferences entitled, The International Symposium on Biological Reactive Intermediates. The first was held at the University of Turku in Finland, in 1975, the second at the University of Surrey in the United Kingdom, in 1980 and the most recent at the University of Maryland in the United States, in 1985. The significance of these conferences has been emphasized by the rapid growth of mechanistic toxicology over the last decade. These conferences were initially stimulated by the attempt to uncover the significance behind the observations that the toxicity of carcinogenic responses produced by many chemicals was associated with the observation that their metabolism led to the formation of chemcially reactive electrophiles which covalently bound to nucleophilic sites in cells such as proteins, nucleic acid or fats. Recently, newer concepts have arisen which have necessitated the expansion of subjects covered by the conference. For example, the application of newer knowledge of the role of active oxygen species in reactive metabolite formation, the concept of suicide substrates, examination of the function of glutathione in cells, application of immunological techniques and molecular biological probes to the solution of toxicological problems all had an impact on the study of the biological reactive intermediates.

Sugar consumption is suspected to play an important role in the pathogenesis of diabetes, cardiovascular disorders, fatty liver disease, and some forms of cancers. Dietary sugars-fructose in particular-also have a potential role in obesity and metabolic diseases. Dietary Sugars and Health presents all aspects of dietary sugars as they relate to health and disease. It provides a review of the current science related to dietary sugars, ranging from historical and cultural perspectives to food science and production to basic research, animal trials, human pathophysiology, epidemiology, and public health policy implications. Each chapter features a concise, thorough summary of the current knowledge, including an overview of cutting-edge research, controversies, and future perspectives. The book provides a balanced approach through global and multidisciplinary contributions as well as input from various sectors, from academia to the food and beverage industry. The overall collection provides readers with a balanced and complete view of the science related to dietary sugars and health. This book is an invaluable reference for food scientists, nutrition scientists, clinical and translational researchers, obesity researchers, physiologists, public health scientists, and policy makers.

Proceedings of the 2nd World Conference - Hormonal and Genetic Basis of Sexual Differentiation Disorders and Hot Topics in Endocrinology. The meeting took place at The Eden Roc Hotel in Miami Beach, Florida, 1/15/10 - 1/17-10. Endocrinology and more specifically, the area of sexual differentiation disorders is an evolving field of medicine. The diagnosis and treatment of Disorders of Sex Development (DSD) is multi-faceted.

The molecular era ushered in the cloning of the growth hormone (GH) gene and the production of unlimited amounts of GH through recombinant technology. The continuing momentum of research from basic science to clinical evaluation has brought unprecedented advances to the understanding of GH biology for the clinical endocrinologist. Growth Hormone Related Diseases and Therapy: A Molecular and Physiological Perspective for the Clinician distills all the new information of relevance to the endocrinologist over the last 20 years by offering five sections: physiology, molecular genetics, GH deficiency, acromegaly and pharmacotherapy. The first section on physiology focuses on GH action.

A review on the structure and function of the GH receptor is followed by a perspective on the regulatory role of ghrelin on GH secretion. The second section on genetics covers pituitary function and adenomas, including new and fascinating information on familial pituitary adenomas, their genotype and phenotype. The adult GH deficiency section spans the epidemiology and diagnosis of GH deficiency with a strong reminder for the clinician that the transition period represents a critical time of somatic maturation, which continues for years after cessation of liner growth. The section on acromegaly focuses on management, giving practical guides to the value of GH and IGF-1 measurements, the place of somatostatin analogues and of radiotherapy while reminding the reader as to why evaluating quality of life is an important part of management. Finally, the section on GH pharmacology takes the reader through innovative developments of long-acting GH formulations with some products on the threshold of clinical use. This section provides a balanced evidence based review of the effects of GH supplementation in aging and in sports where recent data indicates an enhancing effect on a selective aspect of performance. Growth Hormone Related Diseases and Therapy: A Molecular and Physiological Perspective for the Clinician integrates a wealth of information and will prove an invaluable reference for pediatric endocrinologists, adult endocrinologists, endocrine scientists and internists interested in the human biology of GH."

A panel of outstanding investigators surveys and explains the major cutting-edge methods used in thryroid receptor (TR) research and explains their practical experimental details. Described in step-by-step detail to ensure robust experimental results, the techniques presented cover a wide variety of key areas, including TR in development and knockout (mouse and Xenopus), transcriptional regulation by TRs in both cell-free systems and in living cells, and TR mutant analysis of patients. Additional methods provide powerful tools for the isolation of TR-regulated protein complexes, for studying the oncogene v-Erba in blood cell differentiation, and for target gene analysis in the brain. Microarray chip methods are also presented for analyzing the organs of transgenic mice to identify target genes in the liver.

The use of cells for the treatment of a variety of diseases is no longer a dream. Today, blood transfusion, bone marrow transplantation, the use of ex vivo cultured skin in wound healing, and peripheral stern cell transplantation, including the ex vivo expansion of hematopoietic stern cells after high-dose chemo/radiation therapy, are routine. This high standard of knowledge and skills in cell transplantation might also re sult in tackling hitherto untreatable diseases. Organ transplantation is presently the only life-saving treatment for a variety of conditions. Important findings in cell and molecular biol ogy, the identification of hematopoietic, mesenchymal and neuronal stern cells, together with breakthroughs in the methodology for isolat ing, purifying, expanding, and storing human cells could make cellular therapy an alternative to organ transplantation in certain diseases within the next decade. Placental blood may be the source of choice in isolating naive progenitor cells for allogeneic transplantation. Immunotherapy is the most hopeful strategy to date for the treat ment of tumors resistant to chemotherapy, radiation therapy, or hor mone therapy. It includes the use of tumor-infiltrating lymphocytes, ex vivo activated memory T lymphocytes, and cell-based vaccines."

The Temporal Lobe, Volume 187 covers the exponential growth of studies on the relationships between brain and language/cognition, many of which involved the temporal lobe. This volume summarizes research on the anatomy and function of the temporal lobe under both normal and pathological conditions. In addition, it discusses the interactions of the temporal lobe with other brain structures. The book highlights the role of the temporal lobe in language processing as well as vision, object, face recognition and processing. The book also discusses the temporal lobe's role in reading, speech and the processing of color, music, action and memory. Temporal lobe disorders, assessments and treatments are also covered, including encephalitis, Alzheimer's, epilepsy, Korsakov's syndrome, and more.

to the Endothelin System David M. Pollock ascular endothelial cells form a monolayer lining in all of the blood vessels of V the circulation. Initially, they were thought to function as a crude filter allow- ing nutrients from the blood stream to diffuse through to the underlying tissues without letting proteins or blood cells escape. We now know that endothelial cells are important regulators of circulatory function, due in large measure to their rec- ognized ability to synthesize and release many factors that regulate vascular smooth muscle tone. Endothelial-derived factors, including relaxing and contracting sub- stances such as prostacyclin, nitric oxide (NO), and endothelin (ET), have been identified as important contributors in the regulation of vascular tone. Endothe- lial cells have a highly active metabolic function and are involved in clearing a number of agents from circulating blood. In addition, they have the enzyme that inactivates bradykinin and converts angiotensin I into the very potent pressor agent, angiotensin II (Ang II). Endothelial cells also generate various proteins like von Willebrand's factor, tissue plasminogen activator, growth promoting factors and lipids such as platelet activating factor. It is now clear that in addition to the regu- lation of vascular tone and hemodynamics, endothelial cells playa critical role in regulating growth and proliferative processes, inflammation and hemostasis.

Stuart Handwerger, MD and a distinguished panel of clinicians and experts review the most significant recent developments in molecular and cellular biology, powerful advances that have produced new diagnostic methods and improved treatments for many pediatric endocrine diseases. Topics range from the growth hormone/prolactin/placental lactogen gene family and their regulation of growth, to steroid hormones, sexual development, and mineral corticoid action. Additional chapters examine the pathophysiology of insulin-dependent diabetes mellitus, the molecular genetics of thyroid cancer, the molecular basis of hypophosphatemic rickets, and inherited diabetes insipidus. Molecular and Cellular Pediatric Endocrinology offers today's clinicians and researchers not only the latest findings on endocrine diseases in their pediatric manifestations, but also highly practical insights into today's cutting-edge diagnostics, treatment strategies, and powerful new therapeutics.

Endocrine disruption represents one of the most controversial environmental issues of our time. Mounting evidence stemming from more than 10 years of experimental, epidemiological and clinical studies has transformed the once generally discounted subject of endocrine disruptors into an issue of tremendous concern not only within the scientific community but among society as a whole. Following initial evidence from basic research, endocrine disruption in humans has now emerged as a major medical challenge. In this respect, puberty, a crucial developmental stage, has been definitively identified as a key window of vulnerability with regard to endocrine disruptors. Written by leading authorities in the field, Endocrine Disruptors and Puberty offers an engaging and comprehensive overview of this fascinating and rapidly growing problem. An indispensable resource for all clinicians and scientists interested in this challenging endocrinologic topic, Endocrine Disruptors and Puberty is a timely contribution that will help navigate a path toward understanding the problem and developing solutions.

Muscarinic acetylcholine receptors have played a key role in the advancement of knowledge of pharmacology and neurotransmission since the inception of studies in these fields, and the effects of naturally occurring drugs acting on muscarinic receptors were known and exploited for both therapeutic and non-therapeutic purposes for hundreds of years before the existence of the receptors themselves was recognized. This volume presents a broad yet detailed review of current knowledge of muscarinic receptors that will be valuable both to long-time muscarinic investigators and to those new to the field. It describes the detailed insights that have been obtained on the structure, function, and cell biology of muscarinic receptors. This volume also describes physiological analyses of muscarinic receptors and their roles in regulating the function of the brain and of a variety of peripheral tissues. This volume shows how the study of muscarinic receptors continues to provide new and surprising insights not just to the cholinergic system but to the broad areas of neurobiology, cell biology, pharmacology, and therapeutics.

Dr. Robert Volpe and his distinguished contributors comprehensively review the latest thinking about the theoretical, experimental, and clinical aspects of autoimmune endocrine disorders. These world-renowned experts examine the pathogenesis and immunogenetics of these diseases, discuss the role of sex hormones in autoimmunity, and elucidate the nature of autoantigens. They also provide clinical detail on a wide variety of autoimmune endocrinopathies, including autoimmune thyroid disease, Graves' ophthalmopathy and dermopathy, human insulin-dependent diabetes mellitus, and autoimmune adrenocortical failure. Postpartum autoimmune endocrine syndromes, autoimmune hypophysitis, and the polyglandular autoimmune syndromes are also discussed in detail. Comprehensive and authoritative, Autoimmune Endocrinopathies provides today's most up-to-date understanding of the etiology and pathogenesis of autoimmune endocrine diseases.

Introduction Anthony J. Edis, Richard H. Egdahl, Tracy K. Mcintosh, Contents Lester F. Williams xi 1 Surgery of the Parathyroids General Introduction 1 SURGICAL ANATOMY Primary Hyperparathyroidism 7 PATHOLOGY 7 DIAGNOSIS 11 PREOPERATIVE LOCALIZATION STUDIES 22 TREATMENT 27 Secondary Hyperparathyroidism 35 SIGNS, SYMPTOMS, COMPLICATIONS 35 CLINICAL MANAGEMENT 36 Tertiary Hyperparathyroidism 37 Operative Technique 38 CERVICAL EXPLORATION WITH REMOVAL OF A PARATHYROID ADENOMA 46 SUBTOTAL PARATHYROIDECTOMY FOR HYPERPLASIA 59 PARATHYROIDECTOMY FOR CARCINOMA 60 MEDIASTINAL EXPLORATION FOR PARATHYROID TUMOR 61 References 66 2 Surgery of the Thyroid 71 General Introduction 71 SURGICAL ANATOMY 72 Nodular Goiter and Thyroid Carcinoma 79 PATHOLOGY 79 DIAGNOSIS 82 TREATMENT OF THYROID NODULES 94 TREATMENT OF THYROID CANCER RELATED TO PATHOLOGIC TYPE 97 Hyperthyroidism 110 Graves' Disease 111 PATHOLOGY 111 DIAGNOSIS 112 TREATMENT 115 Plummer's Disease 120 PATHOLOGY 120 DIAGNOSIS 120 TREATMENT 122 Complications of Thyroid Surgery 123 PREVENTION AND MANAGEMENT 123 viii CONTENTS 127 Operative Techniques TOTAL THYROID LOBECTOMY 127 REMOVAL OF A SUBSTERNAL GOITER 134 SUBTOTAL THYROID LOBECTOMY 136 MODIFIED NECK DISSECTION FOR PAPILLARY THYROID CARCINOMA 141 References 144 3 Surgery of the Adrenals 151 151 General Introduction SURGICAL ANATOMY 152 Pheochromocytoma 155 PATHOLOGY 155 156 DIAGNOSIS PREOPERATIVE 162 TREATMENT 166 172 Primary Aldosteronism PATHOLOGY 172 DIAGNOSIS 174 178 PREOPERATIVE LOCALIZATION STUDIES TREATMENT 180 Cushing's Syndrome 181 CLASSIFICATION 182 DIAGNOSIS 187 PREOPERATIVE LOCALIZATION STUDIES 192 TREATMENT 194 Adrenal Gland and Metastatic Breast Carcinoma 198 Adrenocortical Carcinoma 200 DIAGNOSIS 201 PREOPERATIVE LOCALIZATION STUDIES AND STAGING 201 TREATMENT 202 PROGNOSIS 203 Nonfunctioning Adrenal Tumors 203

The European Workshops on Molecular and Cellular Endocrinology of the Testis have become by now a well-established tradition. Thanks to their special format, the quality of the main lectures and miniposters, and the vivid discussions, they enjoy the ever-increasing interest and active participation of all European scientists working in the field. Moreover, since the very beginning they have attracted investigators from all over the world. The most recent "Testis Workshop" was held in De Panne, Belgium, from 27-3\ March, 1994. As always, the frame work of the workshop was provided by a series of lectures delivered by a panel of internationally recognized authorities. These lectures are ga thered in the present volume of the Ernst Schering Foundation Work shop series. Together with the Miniposter book they constitute an excel lent written account of the Proceedings of the 8th European Testis Workshop. The testis undoubtedly represents one of the most complex and in triguing tissues in the body. Both its endocrine function, the secretion of male sex hormones, and its exocrine role, the production of mature spermatozoa, continue to raise startling questions to clinicians, physi ologists, endocrinologists, and scientists involved in fundamental re search. Few organs maintain and support a differentiation process as complicated as spermatogenesis; few tissues continually display both mitotic and meiotic cell cyles in such a stringently controlled fashion or a comparable need for coordinated endocrine and local control."

The maintenance of arterial blood pressure and the distribution of blood flow to the various organs of the body depends on the control of the pumping action of the heart and of the resistance of the vascular beds in the individual organs in accordance with their metabolic needs. These controls are achieved through the integrated actions of circulat ing hormones, humoral factors that are synthesized and released in the heart and blood vessels, and the autonomic nervous system. The heart, however, is not only the target for the direct and indirect actions of a number of hormones and humoral factors, it is also an endocrine organ in the traditional sense, synthesizing and secreting into the circulation chemical factors that act at distant sites. In this treatise, Hormones and the Heart in Health and Disease, we interpret "endocrinology" broadly and consider traditional hormones as well as autocoids that are secreted by the heart or that act on it. In this overview, the relevant chapters are indicated in parentheses. The discovery of atrial natriuretic peptide (ANP; atrial natriuretic factor, ANF) in the 1980s indicated that the heart does indeed function as an endocrine organ in the classic sense. ANP (Chapter I) is synthesized in the heart and secreted into the circulation for actions on the kidney, where it is a potent natriuretic agent, and on the vasculature, where it causes vasodilation. ANP can also affect myocardial contractility.

Key workers in vascular medicine and biology apply state-of-the-art techniques in cell and molecular biology to study the endothelial and vascular smooth muscle cells. The distinguished scientists and clinicians open a new area of endocrinology, which sees the vasculature and kidney as endocrine organs and sheds new light on the hormonal regulation of the cardiovascular system. They also add significantly to our current understanding of the autocrine, paracrine, and endocrine regulation of vascular function in health and in those vascular disease states that accompany diabetes mellitus, dyslipidemia, and hypertension. Endocrinology of the Vasculature is the first book to comprehensively and systematically explore the vasculature as an endocrine organ.