Leading clinicians review in depth the clinical and molecular aspects of the hormone resistance syndromes caused by receptor mutations. These mutations are involved in a large number of disorders, including dwarfism, Laron syndrome, pseudohypoparathyroidism, insulin resistance, resistance to thyroid hormone, glucocorticoid resistance, hereditary resistance to vitamin D, and estrogen resistance. Throughout, the book's distinguished contributors not only summarize the clinical features of these and related disorders, but also illuminate their molecular bases. Hormone Resistance Syndromes provides an authoritative summary and standard reference for all those clinicians and researchers actively studying these mutations today and affords a unique opportunity to understand hormone action in normal physiology.

A cutting-edge review of how derangements in the hormonal and growth factor mechanisms controlling normal mammary development lead to breast cancer. Drawing on the multidisciplinary expertise of leading authorities, the book highlights the roles of oncogenes and tumor suppressor genes, spelling out the importance of autocrine/paracrine loops (e.g., stromal epithelial interactions) in supporting breast cancer cell proliferation and the progression to hormone independence. The book's many prominent contributors also illuminate significant recent advances in the biochemistry and physiology of hormone receptors and review the state-of -the-art in the endocrine therapy of breast cancer. Endocrinology of Breast Cancer provides a unique integrated overview of the most significant basic and clinical developments concerning the hormonal aspects of breast cancer.

Leading clinical and basic science researchers present the latest molecular and cellular findings on key gut peptides, illuminating their physiology and pathophysiology, as well as highlighting the regulatory mechanisms underlying their action in the intestinal tract. The book focuses on gut peptide physiology and receptor pharmacology, gut processing and receptor biology, and on regulatory mechanisms in the gut, including pancreatic feedback mechanisms. Also included are chapters on the trophic effects of gut peptides on GI and pancreatic cancer; the regulation of gut peptide gene expression; and gastric secretion, especially in diseased states.

Because of its relative rarity and favorable outcome, it has not been feasible to assess medical interventions for thyroid cancer using randomized prospective trials. The approach to diagnosis and treatment relies to a great extent on information derived from retrospective studies. Overall prognosis and survival rates have been edging upward over the past two decades. This is attributed to a wider acceptance of total thyroidectomy as the primary surgical strategy. The appropriate indication of radioiodine therapy remains controversial, and physicians must be familiar with staging criteria to make educated decisions. We are now beginning to understand the genetic mechanisms of thyroid tumor initiation and progression. There are still major challenges ahead. Thyroid Cancer provides comprehensive updates on the epidemiology, pathogenesis, diagnosis and treatment of thyroid neoplasms. Although the material should be of particular interest to scholars in the field, the contributors have striven to make it of practical use to physicians who treat patients with thyroid disease.

Endocrinology of Cardiovascular Function is a fitting inauguration to the Endocrine Update Series. The aim of these publications is to provide the clinician with cutting edge, yet succinct, access to the latest advances in endocrinology. Historically, our understanding of hormonal disturbances was restricted to the classical secretory glands and their targets. As Endocrinology of Cardiovascular Function so aptly indicates, endocrinology is no longer constrained by our early physiologic understanding of glandular disorder. Endocrinology of Cardiovascular Function has set the standard of excellence for the future volumes in this series. Shlomo Melmed, M.D. Series Editor, Endocrine Update Growth factors such as IGF-1 play important roles in cardiovascular cell hypertrophy and the response to acute vascular injury. From another perspective, traditional endocrine hormones, such as estrogen, have been found to participate in preventing the development of atherosclerosis in women, acting through novel mechanisms on target vascular cells. Other endocrine' hormones, such as PTHRP and adrenomedullin, also modulate cardiovascular and renovascular dynamic states, suggesting new roles for these peptides as vasodilators. This multi-authored text is dedicated to highlighting emerging and important new information regarding the endocrinology of the cardiovascular system. Ellis R. Levin, M.D.

A comprehensive, cutting-edge review of the complex interactions between maternal and fetal-placental tissues that control the establishment and maintenance of pregnancy, the proper development of the fetus, the birth process, and the behavioral aspects of bonding between mother and newborn. Expert researchers review the endocrine and physiological events that culminate in the delivery of offspring, and provide a solid base of comparative information on the menstrual cycle of primates, including humans. They also discuss the sources and functions of both steroid and protein hormones from the placenta and the details of their effects on uterine function, placental development, fetal growth and well-being, and maternal responses to pregnancy. This book will become the standard reference source not only for reproductive scientists, but also for those clinicians who want better to understand the complex factors that affect pregnancy-and their pregnant patients.

As an endocrinologist and research scientist--and a diabetic for over 29 years--Dr. Joseph Juliano has devoted his life to understanding the disease. Now, he shows the millions of Type I, insulin-dependent diabetes sufferers how to avoid complications and overcome them if they occur, empowering readers with the motivation and information to control their disease.

The author, blind since 1984 from complications of diabetes, talks about his own experiences.

"Theoretically, one should obtain essentially the same clinical picture from failure of an end-organ to respond to a hormone as from a decreased production or absence of said hormone. " With these words, Fuller Albright began his now classic paper describing a novel disease, pseudo hypoparathyroidism (PHP), and a novel concept, hormone resis- tance as a cause of disease. Soon, other hormone resistance disorders such as nephrogenic diabetes insipidus (NDI) were recognized, and the concept was extended to resistance to other substances such as calcium ions in familial hypocalciuric hypercalcemia (FHH). Later, diseases characterized by excess rather than deficient hormone action such as McCune-Albright syndrome (MAS) and familial male precocious puberty (FMPP) were recognized to be caused by autonomous endocrine hyperfunction. Although many i!!vestigators provided careful and detailed descriptions of the clinical features of these and other related endocrine disorders, an understanding of pathogenesis proved elusive for many years. In just the past few years, we have gone from clinical description to a molecular understanding of these interesting disorders. This remarkable progress reflects a synthe- sis of three distinct, but now overlapping, areas of biomedical research: the aforemen- tioned recognition and careful clinical description of specific diseases, the elucidation of the basic mechanisms of signal transduction, and the application of the powerful tools of molecular biology and genetics. Fundamental studies on the mechanisms of hormone action by Rodbell and colleagues at NIH culminated in the discovery of a major signal transduction pathway involving heterotrimeric G proteins.

Male infertility is a clinician-orientied book aimed at the clinician dealing with the infertile couple because rational, effective management is only possible if the couple are considered together. The aim of the work is to provide advice to the clinician and to give reference to the underlying science. This will not only enable clinicians to understand the underlying science but will also give scientists an insight to clinical work. This blend of science and clinical work is reflected in the contributors who are experts drawn from both fields.

This important title brings together a distinguished panel of thought-leaders, known for their insights into the development and application of minimally-invasive surgical and endovascular techniques, to provide a comprehensive and discerning compendium of our most current knowledge and state-of-the-art procedures in the management of cerebral vascular diseases. Written in a style that is accessible to students and experienced practitioners alike, the book covers all the important recent advances that have reshaped the field in dramatic ways. Emphasizing how surgical and endovascular techniques are complementary, the volume includes illuminating chapters on the nexus of endovascular and conventional "open" cerebrovascular surgery, including patient assessment and practice in a hybrid operating environment, utilizing the best methods to achieve optimal outcomes. A major addition to the clinical literature, Management of Cerebrovascular Disorders: A Comprehensive, Multidisciplinary Approach will be of significant interest to neurosurgeons, neurologists, neuroradiologists, neurointensivists, students, residents, fellows, and specialized attending physicians.

Nineteen cutting-edge review articles by leading authorities provide a comprehensive overview of the normal function of the pituitary and of the diagnosis and treatment of pituitary disorders. Topics range from normal hypothalamic-pituitary interactions and the processes that disrupt them to new advances in pituitary imaging and appropriate surgical intervention in various pituitary disorders. Among the diseases discussed are congenital hypopituitarism, deficiency states, strategies for evaluating patients with hyperprolactinemia, Cushing's syndrome, acromegaly, and glycoprotein pituitary tumors.

A comprehensive, state-of-the-art review of the biochemistry, molecular and cellular biology, pharmacology, physiology, and pathology of natriuretic peptides. Written by the foremost researchers in the field, the reviews range from describing the actions of these peptides on the kidney, adrenal gland, vasculature, and brain, to their effects on immune regulation, reproduction, and cell growth. Special attention is given to the potential involvement of these hormones in clinical pathology and to their possible therapeutic use. Especially enlightening is the first-time review of molecular understanding of key cellular signaling pathways and of the importance of the vascular smooth muscle-endothelial interface.

Expert clinicians comprehensively review the endocrine and metabolic responses to critical illness, explore the mechanisms and outcomes (positive and negative) of those responses to severe stress, and consider possible endocrine interactions that are not yet fully defined. The contributors explain in detail the endocrine response to a multitude of critical illnesses, including cancer, liver failure, renal failure, trauma, burns, AIDS and other infections, starvation, cardiac disease, pulmonary disease, and organ transplants. The book offers significant basic knowledge of high clinical relevance by collating and defining the numerous interactions of the endocrine system and critical disease states, by discussing the basic pathophysiological processes involved, and by reviewing the clinical relevance of such responses.

Take control of your weight--and your diabetes. Managing your weight is critical when you have diabetes. In fact, losing as little as 10 to 20 pounds can improve diabetes control. With this innovative book, you can manage your weight and your diabetes by making gradual lifestyle changes you'll be able to live with for the rest of your life--like following a low-fat meal plan, becoming more active, and managing stress. Weight Management for Type II Diabetes will help you assess habits, teach you techniques of behavior change, and motivate you to find the support you need to manage both diabetes and your weight. This interactive guide takes you through the steps of developing a personalized plan that considers your lifestyle, personality, family situation, and wants and needs. Authors Jackie Labat, MS, RD, CDE, and Annette Maggi, MS, RD, will help you:
* Set reasonable goals
* Keep pace with an exercise program
* Design your own meal plan
* Handle special occasions
* Manage stress
* Learn to deal with lapses
The book also provides fat and calorie counts, grocery shopping tips, and a lesson in low-fat cooking.

Peroxisomal disorders constitute a major research front in clinical genetics, paediatrics and cell biology. Since 1983, the metabolic defect in some 20 different peroxisomal disorders has been described. The best known conditions include Zellweger syndrome, rhizomelic chondrodysplasia punctata and X-linked adrenoleukodystrophy and, in the most recent edition of The Metabolic and Molecular Basis Inherited Disease, edited by Scriver and colleagues, more than 100 pages are now devoted to the subject. Progress in our understanding of these conditions, and their diagnosis, results from the application of a variety of laboratory investigations. These include microscopic studies, analysis of metabolites (very long-chain fatty acids, bile acids, and plasmalogens), enzyme studies (peroxisomal beta-oxidation pathway and dihydroxyacetone phosphate acyltransferase), immunodetection of peroxisomal (membrane) proteins and molecular analysis of mutant DNA. In order to encourage a greater awareness in this field and the diagnostic protocols required, an international course was organised in Gent, Belgium, in May 1994, on the clinical and biochemical diagnosis of peroxisomal disorders. A number of international experts in the field who provided intensive hands-on experience over 3.5 days, have now collected their course work and reviews together in this Handbook. The volume is introduced by Sidney Goldfischer, who in 1973 was the first to recognise the absence of peroxisomes in Zellweger syndrome, but whose observations were not fully appreciated for a further decade. This handbook provides the most comprehensive and detailed account of laboratory methods for the diagnosis of peroxisomal disorders. The methods are clearly presented and well illustrated, and should allow laboratories to introduce these methods into their repertoire. Audience: Paediatricians, neurologists, clinical biochemists, pathologists, genetic counsellors, obstetricians, and GPs interested in the recognition, diagnosis and prenatal prevention of peroxisomal disorders.

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.

In vitro and animal studies show that vanadate and other Because most cellular components contain hydroxyl and/or vanadium compounds increase glucose transport activity and phosphate groups, vanadate reacts as shown in eq. 1, and 2 normalize glucose metabolism [1-5]. Furthermore, these with a variety of metabolites. For example, the reaction of insulin-mimetic compounds can be administered orally. Vana- vanadate with the 2'-hydroxyl group of the cofactor NAD date enhances the phosphoprotein formation which is attrib- generates an NADP analog, NADV (path b) [22]. NADV is uted to either the activation of protein kinases or inhibition an excellent cofactor for enzymes such as glucose-6-phos- of protein phosphatases. Despite the interest in document- phate dehydrogenase, 6-phosphogluconate dehydrogenase, ing the effects of vanadate on protein kinases, most reports and alcohol dehydrogenase [22]. The presence ofNADV have used indirect methods and studies with purified kinases could affect the levels of reducing equivalents in the cell, im- show weak, if any, interaction of vanadate with kinases as portant in maintaining a normal glucose metabolism. This a group of enzymes (reviewed in Refs. [6-8]). Vanadate type of mechanism is distinct from the vanadate-induced interacts potently with phosphatases and the inhibition is NADH oxidation by plasma membranes [23]. Organic attributed to a five-coordinate vanadate complex which vanadates have been shown to substitute for organic phos- mimics the transition state of the phosphate ester hydroly- phates in many of the enzymes related to glucose metabolism sis reaction (reviewed in Refs. [7,9]).

Tamoxifen has persisted as a widely accepted and administered drug for almost 25 years. Following the many scientific papers and books on the subject, it has remained a very intriguing substance. This, perhaps, is the reason for another monograph on Tamoxifen. It is regrettably true that overviews, even when up to date after exhaustive research - the shibboleth of our cultures -, rapidly lose relevance with the passage of time. Scientists can sometimes be pictured as deep sea divers, who plunge into the unknown in search of a hitherto unknown world. Their descent is exciting, but eventually they must come up for air and integrate their experiences with others who also had to resurface. This book intends to collect and, where possible, to collate recent, but sometimes seemingly unrelated information. To quote Stephane Mallarme: "Everything in the world exists to end up in a book." Even if this is a tad cynical, it might not be far from the truth. If a little knowledge is a dangerous commodity, one can also add - tongue in cheek - that a vast amount of knowledge can be truly hazardous. It is likely that what might seem as entangled data is confusing, especially for those satisfied with the comfortable interpretation of Tamoxifen as an antiestrogen which has long been found insufficient. The complexity of its mechanisms and effects defies simple explanations and may even seem capricious, but only because of our ignorance.

Crash Course - your effective every-day study companion PLUS the perfect antidote for exam stress! Save time and be assured you have the essential information you need in one place to excel on your course and achieve exam success. A winning formula now for over 20 years, each series volume has been fine-tuned and fully updated - with an improved full-colour layout tailored to make your life easier. Especially written by senior students or junior doctors - those who understand what is essential for exam success - with all information thoroughly checked and quality assured by expert Faculty Advisers, the result are books which exactly meet your needs and you know you can trust. Each chapter guides you succinctly through the full range of curriculum topics, integrating clinical considerations with the relevant basic science and avoiding unnecessary or confusing detail. A range of text boxes help you get to the hints, tips and key points you need fast! A fully revised self-assessment section matching the latest exam formats is included to check your understanding and aid exam preparation. The accompanying enhanced, downloadable eBook completes this invaluable learning package. Series volumes have been honed to meet the requirements of today's medical students, although the range of other health students and professionals who need rapid access to the essentials of metabolism and nutrition will also love the unique approach of Crash Course. Whether you need to get out of a fix or aim for a distinction Crash Course is for you! Provides the exam syllabus in one place - saves valuable revision time Written by senior students and recent graduates - those closest to what is essential for exam success Quality assured by leading Faculty Advisors - ensures complete accuracy of information Features the ever popular 'Hints and Tips' boxes and other useful aide-memoires - distilled wisdom from those in the know Updated self-assessment section matching the latest exam formats - confirm your understanding and improve exam technique fast

Cryptorchidism remains a common but poorly understood anomaly affecting 2%-5% of children. Major controversies exist over the timing and type of treat ment (i. e. surgical vs hormonal therapy) and whether intervention prevents sub sequent infertility and testicular cancer. Part of the dilemma is caused by lack of understanding of the normal process of descent, despite intensive research and study since the eighteenth century, when Hunter and von Haller first described the gubernaculum (caudal genito-inguinal ligament) and processus vaginalis (Williams and Hutson 1991a). More needs to be known, not only of the normal mechanism, but also of the ways that it can be deranged to produce undescended testes. This review describes the recent results of studies on normal descent, with emphasis on our studies of the different stages of descent. As the reader will appreciate, the ever-more complex models proposed to account for normal tes ticular descent predict that undescended testes will be caused by a multitude of anomalies affecting different stages of the process. A description is given of current hypotheses of the aetiology of cryptorchidism, correlating these with studies of cryptorchid animal models. For a more detailed description of the numerous ideas about the mechanism, the reader is referred to Heyns and Hutson (1995) and other monographs (Fonkalsrud and Mengel 1981; Abney and Keel 1989)."

This book contains the necessary knowledge and tools to incorporate nutrition into primary care practice. As a practical matter, this effort is led by a dedicated primary care physician with the help of motivated registered dietitians, nurses, psychologists, physical therapists, and office staff whether within a known practice or by referral to the community. It is essential that the nutrition prescription provided by the physician be as efficient as possible. While many team members have superior knowledge in the areas of nutrition, exercise, and psychology, the health practitioner remains the focus of patient confidence in a therapy plan. Therefore, the endorsement of the plan rather than the implementation of the plan is the most important task of the physician. This book proposes a significant change in attitude of primary health care providers in terms of the power of nutrition in prevention and treatment of common disease. It features detailed and referenced information on the role of nutrition in the most common conditions encountered in primary care practice. In the past, treatment focused primarily on drugs and surgery for the treatment of disease with nutrition as an afterthought. Advanced technologies and drugs are effective for the treatment of acute disease, but many of the most common diseases such as heart disease, diabetes, and cancer are not preventable with drugs and surgery. While there is mention of prevention of heart disease, this largely relates to the use of statins with some modest discussion of a healthy diet. Similarly, prevention of type 2 diabetes is the early introduction of metformin or intensive insulin therapy.

Managing Treatment-Resistant Depression: Road to Novel Therapeutics defines TRD for readers, discussing the clinical and epidemiological predictors, economic burden and neurobiological factors. In addition, staging methods for treatment resistance are fully covered in this book, including serotonin specific reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, other classes of antidepressants, including tricyclic antidepressants and monoamine oxidase inhibitors, augmentation strategies, and newer antidepressant treatments like ketamine and esketamine. In addition, evidence supporting the use of psychotherapies and neuromodulation strategies are also reviewed. Written by top experts in the field, this book is the first of its kind to review all methods of treatment for TRD.

Craniopharyngioma represents a major challenge for neurosurgeons, pediatricians, and endocrinologists. This so-called benign tumor is a real threat to quality of life and life itself. This book discusses the various therapeutic strategies and suggests multimodal treatment approaches, including microsurgery, stereotaxis, and alternative treatments. The rationale for choice of therapy is supported by biological, clinical, and neuroradiological data and therapeutic results of a large series of case studies from all over the world are reported. Finally, guidelines for further development and new topics for research and treatment are offered.

Recent progress in recombinant DNA technology and the availability of a number of nonpeptide subtype-specific receptor antagonists and of specific antibodies to components of prorenin-renin-angiotensin system (PRAS) have led to rapid advances in the under standing of the multifaceted role of angiotensin II, classically known as a peptide hormone of cardiovascular homeostasis. Accumulating evidence sug responsible for the regulation gests that, in addition to its role in salt and water metabolism, PRAS may control other physiological functions including neurosecretion, cellular proliferation, hypertrophy and/or differentiation, angiogenesis and gonadal function. At the same time, it is becoming evident that the specialized functions of endocrine glands are not only regulated by trophic hormones but also by locally produced paracrine/autocrine factors. The concept is emerging that tissue PRAS is one such locally active regulatory system. With more and more reproductive and endocrine organs being added to the list of tissues that contain a local tissue PRAS, questions are being raised by the reproductive biologists and endocrinologists as to the role of such systems in the tissues of their interest. On the other hand, the cardiovascular and renovascular physiologists are wondering about the relevance of PRAS in various peripheral tissues compared to those of the classical cardiovascular organs. It appeared, therefore, that the time was ripe for a meeting to consider a merger of interest in these two important but heretofore distinct areas of physiology."