Adrenal Glands Diagnostic Aspects and Surgical Therapy by Dimitrios A. Linos, Jon A. van Heerden

By Dimitrios A. Linos, Jon A. van Heerden

- Over two hundred beautiful illustrations, starting from intraoperative pictures, line drawings, diagnostic photos, pathology slides, tables and graphs can be found to make every one case mentioned understandable and straightforward to follow.
- conventional and novel healing strategies are introducedand the newest advancements in minimal-access operative innovations are mentioned and reviewed.
- makes a speciality of a teamwork orientated method that identifies the mandatory communications among the various clinical disciplines while facing adrenal issues.

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Lange, New York, pp 797–813 9. Dyson M (1995) Endocrine system. In: Bannister LH, Berry MM, Collins P, Dyson M, et al (eds) Gray’s anatomy. Churchill Livingstone, New York, pp 1882–1907 10. Edis AJ, Grant CS, Egdahl RH (1984) Surgery of the adrenals. In: Edis AJ, Grant CS, Egdahl RH (eds) Manual of endocrine surgery. Springer-Verlag, New York, pp 151– 242 11. Jossart GH, Burpee SE, Gagner M (2000) Surgery of the adrenal glands. Endocrinol Metab Clin North Am 29:57–68 12. Kebebew E, Duh QY (2001) Operative strategies for adrenalectomy.

Thus,locally secreted CRH has proinflammatory properties, whereas central CRH alleviates the immune response [26, 39]. 2 HPA Axis: Other Endocrine Axes The HPA axis is closely linked to the endocrine axes that control reproduction and growth. The survival of the individual and the species in general requires adequate nourishment, growth and reproduction, which are achieved through biologically costly pathways that threaten the stability of the internal milieu. Under conditions of serious danger to survival, the stress-dependent HPA axis activation intervenes to exert multilevel inhibitory effects on the gonadal and growth axes, until the imposed challenge is counteracted.

Finally, a reciprocal interaction between CRH and the sex hormones is suggested by the presence of estrogen responsive elements in the promoter area of the CRH gene and by the direct stimulatory effects that estrogen exerts on CRH gene expression [126]. This finding implicates the CRH gene and consequently the HPA axis as a potentially important target of ovarian steroids and a potential mediator of gender related differences in the stress response and HPA axis activity. 2 Growth Axis Growth is also sacrificed in order to preserve homeostasis under stressful conditions through a variety of inhibitory effects mediated by the HPA axis (Fig.

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