As a result of the rapidly growing rate of obesity worldwide, clinicians are struggling to provide the best strategies for treating obese patients with concomitant pulmonary conditions. Obesity does not simply change the epidemiology of pulmonary disease; obesity has a profound impact on the pathophysiology of common pulmonary diseases. Obesity affects the severity of asthma, response to treatment, and is likely a major modifier of the phenotype of asthma. Obesity also appears to affect response to pathogens, and as such has a major influence on response to pneumonia, and has a significant impact on outcomes pertaining to acute lung injury in the intensive care unit. Obesity and Lung Disease: A Guide to Management is the first text in the field to cover the full range of issues related to managing obese patients with pulmonary problems. All the relevant conditions, in the context of obesity, are covered, including airway inflammation, sleep apnea, asthma, pulmonary hypertension, obesity hypoventilation, as well as others. Written by an international group of experts, this important new volume is an invaluable resource for all clinicians and scientists concerned with the challenging problems surrounding obesity and lung diseases.

Creating clinical guidelines is a modern trend. Published studies pertaining to a given theme are collected, their credibility evaluated, and then treatment options in the form of evidence-based guidelines are offered. There are a number of guidelines for the treatment of thyroid tumors that have established positions in clinical practice in North America and in Western European countries. In Japan, however, where radioisotope facilities are of limited availability, treatment plans for differentiated thyroid cancer differ considerably from those of America and Europe, and the associated clinical guidelines need modification before they can be adopted. In addition, although thyroid tumor is a common disease in endocrine practice, its management can differ even among specialists. Thus, a Japanese clinical guideline for the treatment of thyroid tumor was desired by many clinicians. As a combination of evidence-based and consensus-based guidelines for the treatment of thyroid tumor, this book offers alternatives to conventional approaches in the West. Ultimately, the authors hope the guideline will lead to the best possible treatment for patients all over the world in the not-distant future.

Why sex matters Among human and nonhuman animals, the prevalence and intensity of infection typically is higher in males than females and may reflect differences in exposure as well as susceptibility to pathogens. Elevated immunity among females is a double-edged sword in which it is beneficial against infectious diseases but is detrimental in terms of increased development of autoimmune diseases. The present book critically reviews the evolutionary origin and the functional mechanisms responsible for sexual dimorphism in response to infection. It emphasizes the value of examining responses in both males and females to improve our understanding about host-pathogen interactions in both sexes. The contributors are experts in their specific disciplines which range from microbiology and immunology to genetics, pathology, and evolutionary biology. The book aims at bringing insight to the treatment and management of infectious diseases; it delineates areas where knowledge is lacking and highlights future avenues of research.

Kisspeptin has been shown to be both necessary and sufficient for activation of the reproductive axis, during puberty and later in adulthood. This makes kisspeptin a fundamental component of the reproductive axis. Kisspeptin has been deemed the single most potent stimulator of GnRH neurons yet known. The importance of kisspeptin has been documented in humans as well as non-human animal models, ranging from monkeys, sheep, and rodents to numerous fish species, thus signifying a highly conserved nature of its reproductive function. Importantly, kisspeptin neurons seem to mediate many of the regulatory effects of other signals, whether they are metabolic, circadian, hormonal, or stress. This places kisspeptin neurons in a unique position to be key nodal points and conduits for conveying numerous endogenous and exogenous signals to the reproductive axis.

Molecular biology emerged from advances in biochemistry during the 1940s and 1950s, when the structure of the nucleic acids and proteins were elucidated. Beginning in the 1970s, with nucleic acid enzymology and the discovery of the restriction enzymes, the tools of molecular biology became widely available and applied in cell biology to study how genes are regulated. This new knowledge impacted endocrinology and reproductive biology since it was largely known that the secretion of the internal glands affected the phenotypes, and expression of genes. Modern reproductive biology encompasses every level of biological study from genomics to ecology, encompassing cell biology, biochemistry, endocrinology and general physiology. All of these disciplines require a basic knowledge, both as a tool and as an essential aid to a fundamental understanding of the principles of life in health and disease. Overall, molecular biology is central to scientific studies in all living matter, impacting disciplines such as medicine, related health sciences, veterinary, agriculture and environmental sciences. In this book, the basic biochemistry of nucleic acids and proteins are reviewed. Methodologies used to study signaling and gene regulation in the endocrine/reproductive system are also discussed. Topics include mechanisms of hormone action and several endocrine disorders affecting the reproductive system. Professionals in the medical, veterinary and animal sciences fields will find exciting and stimulating material enhancing the breadth and quality of their research.

Responding to a renewed interest in the growing problem of iodine deficiency worldwide, Drs. Charles Oxnard and Peter Obendorf, along with experienced translator and anatomist John Dennison, take a fresh look at the classic text, Der endemische Kretinismus, published in 1936 by Springer. Translated here for the first time into English, this landmark text will be a welcome resource for researchers confronting the problem of iodine deficiency. Oxnard and Obendorf point out that there is very little detailed knowledge or numerical data on cretinism available in the English-speaking world. In addition, highly-renowned Professor Basil S. Hetzel, recently-retired World Health Organization Chairman of the International Council for Control of Iodine Deficiency Disorders, published in 2009 with Dr Chen Zu-pei on the resurgence of iodine deficiency in China. Indeed, throughout the entire developing world there may be as many as two billion people at risk to iodine deficiency; perhaps three quarters of a billion have goiter, and ten million may be cretins. Even in developed countries, iodine deficiency is re-emerging (as in New South Wales in 19% of children) with the result of significantly reduced numbers of gifted children (though this is not cretinism per se). Certain to be of significant interest to a wide range of researchers, health providers and professionals, including government health administrators, this English translation of Endemic Cretinism is a major contribution to the literature.

Genomics in Endocrinology focuses on exciting new advances in endocrinology resulting from DNA microarray studies and includes a comprehensive introduction to the use of DNA microarrays in endocrinology. The text provides the basis for further understanding of the usefulness of microarray analyses in endocrinology research. Topics discussed include the methodology of DNA microarrays and general methods for the analysis of microarray data.

Since its ?rst description in 1942 in both serum and cerebrospinal ?uid, transthyretin (TTR) has had an eventful history, including changes in name from "prealbumin" to "thyroxine-binding prealbumin" to "transthyretin" as knowledge increased about its functions. TTR is synthesised in a wide range of tissues in humans and other eutherian mammals: the liver, choroid plexus (blood- cerebrospinal ?uid barrier), retinal pigment epithelium of the eye, pancreas, intestine and meninges. However, its sites of synthesis are more restricted in other vertebrates. This implies that the number of tissues synthesising TTR during vertebrate evolution has increased, and raises questions about the selection pressures governing TTR synthesis. TTR is most widely known as a distributor of thyroid hormones. In addition, TTR binds retinol-binding protein, which binds retinol. In this way, TTR is also involved with retinoid distribution. More recently, TTR has been demonstrated to bind a wide variety of endocrine disruptors including drugs, pollutants, industrial compounds, heavy metals, and some naturally occurring plant ?avonoids. These not only interfere with thyroid hormone delivery in the body, but also transport such endocrine disruptors into the brain, where they have the potential to accumulate.

The revised and updated fourth edition of Practical Endocrinology and Diabetes in Children offers a practical, highly clinical and up-to-date handbook of paediatric endocrinology and diabetes. The book is written in clear terms and offers a user-friendly format that is designed to be concise, yet comprehensive.. The international panel of expert contributors explore the range of endocrine disorders in children including growth, thyroid, adrenal and problems related to puberty.

The prevalence of hypertension is almost three times as high as that of diabetes mellitus type 2, with both conditions being major risk factors for stroke, ischemic heart disease, cardiac arrhythmias, and heart failure. The exact prevalence of hypertension related to hormonal derangements (endocrine hypertension) is not known but estimated to affect less than 15% of hypertensive patients. Recent scientific discoveries have increased the understanding of the pathophysiologic mechanisms of hypertension. In Endocrine Hypertension, a renowned panel of experts provides a comprehensive, state-of-the-art overview of this disorder, discussing when to assign an endocrine cause in one of many conditions that may present with hypertension. The first part of Endocrine Hypertension is dedicated to adrenal causes. The second part of the volume concerns potential nonadrenal causes of hypertension, such as growth hormone excess or deficiency, primary hyperparathyroidism, vitamin D deficiency, testosterone deficiency, insulin resistance, obesity-associated hypertension, and the role of central mineralocorticoid receptors and cardiovascular disease. An important contribution to the literature, Endocrine Hypertension is an indispensable reference not only for endocrinologists, diabetologists, and adrenal investigators, but also for translational scientists and clinicians from cardiology, internal medicine, pediatrics, family medicine, geriatrics, urology, and reproductive medicine / gynecology.

Originally presented as the author's thesis (doctoral--Technical University of Denmark).

Stjarne: The present review puts the emphasis on two important developments: the discovery that individual postganglionic sympathetic neurons may secrete multiple transmitter substances from different classes of vesicles and by different mechanisms, and the introduction of new techniques which may permit for the first time direct impulse by impulse analysis of transmitter secretion in individual sympathetic nerve varicosities. Illes: Exogenous and endogen opioid peptides elicit a number of effects in the organism, usually by modifying the function of transmitter and hormone systems, for example, activation of multiple opioid receptors. The effects of opioids on transmitter and hormone release have frequently been reviewed. This review gives a detailed overview on the involvement of multiple opioid receptors in these processes. Rothstein: This article gives an overview of the exchange in acidification and transepithelial salt and water transfer in nonepithelial cells. Delineating the exchanger's most important, common features, and concentrating particularly on its role in cell pH and volume regulation.

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.

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.

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

captured for the published proceedings. Nevertheless, the two Supplements to this Journal (also available together as a hard-backed book) do, over the years, embrace many of the major aspects of the study of inborn errors of metabolism and can, particularly with the Short Communications section, be used as a way into the literature on specific new topics. We hope that with judicious selection of material these supplements will continue to provide, as did the Society's earlier annual publications, a balanced record of the present state of the subject in all its facets, a record of interest to those working in allied fields as well as to the specialist. R. J. Pollitt G. M. Addison R. A. Harkness The papers listed below were also presented at the meeting. Scripts were not available by the time of publication. 1. Tangier disease and related disorders of apolipoprotein Al. G. Assmann, Munster. 2. Contribution to Ethics Symposium by M. E. Pembrey, London.

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."

This book is the2nd improved and expanded edition of "Clinical Enzymology" (Lott/Wolf, 1987). It includes case studies and guidelines for specialists of laboratory medicine and clinicians, devotes each chapter to a specific enzyme or protein marker, contains case studies and guidelines, a section on marker biochemistry and physiology as well as a section on special pathology and analysis. The clear, didactic structure and the multiple choice questions also make the book valuable reading for graduate students in the fields of clinical pathology and laboratory medicine.

Breast and prostate cancers are both hormone-dependent, at least in some stages of their progression. Hormonal manipulation represents an important therapeutic approach. Although most of breast and prostate cancers initially respond to hormone therapy, most tumors reinitiate to growth. Finally, hormone-resistant and metastatic breast and prostate cancers may develop. Thus, the challenge is the dissection of mechanisms by which steroid receptor signaling pathways continue to influence cell growth and invasiveness. Compelling evidence indicates that steroid hormones elicit non-genomic responses in extra-nuclear compartment of target cells. In this cellular location, steroid-coupled receptors rapidly recruit signaling effectors or scaffold proteins and activate multiple pathways leading to proliferation, survival, migration and invasiveness. The immediate challenge is the dissection of key events regulating the steroid response of target tissues to prevent progression and improve treatment of breast and prostate cancers.

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.

It has been known for over 150 years that hallmarks of inflammation can be observed in the wall of atherosclerotic vessels. It was, however, not clear if this inflammation is the cause or the consequence of atherogenesis. More recently, it has become evident that inflammation mediated both by innate and adaptive immunity is instrumental even in the earliest stages of the development of atherosclerotic lesions, i.e., that it plays an important pathogenetic role. In this volume, international experts in the field discuss the pathogenetic, diagnostic, preventive and possible therapeutic relevance of inflammation in atherogenesis. This book is intended for researchers and physicians in the fields of vascular biology, immunology and atherosclerosis.

The volume Appetite Control provides a comprehensive description of the mechanisms controlling food intake, and thereby energy balance, in the mammalian organism. During the last decade, research in this area has produced a remarkable wealth of information and has characterized the function of numerous peptides, transmitters, and receptors in appetite control. Dysfunction of these circuits leads to obesity, a growing health concern. However, the plethora of mechanistic information is in marked contrasts to an almost complete lack of anti-obesity drugs that meet the safety standards required for the chronic therapy of morbid obesity. Consequently, ongoing research aims to identify additional targets and agents for a pharmacological intervention. Thus, the mechanisms of appetite control as well as all agents interfering with its control are of considerable practical interest.

The authors of the volume are distinguished scientists who are leading experts in the field, and who have contributed important, original data to our understanding of the mechanisms of appetite control. They have quite different scientific backgrounds and, together, they represent all relevant disciplines. Thereby, the topics are presented from different points of view, not exclusively from that of pharmacology and neuroendocrinology. Thus, the volume addresses all scientists who are interested in the field of obesity research and the pathophysiology of appetite control."

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.

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

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. "