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

By Dimitrios A. Linos, Jon A. van Heerden

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

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Additional resources for Adrenal Glands Diagnostic Aspects and Surgical Therapy

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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. 1 Gonadal Axis The reproductive axis is inhibited at all levels by various components of the HPA axis (Fig. 5) [72, 86, 95]. At the hypothalamic level, CRH suppresses the gonadotropin hormone releasing hormone (GnRH) neurons of the arcuate nucleus. CRH-induced b-endorphin secretion by the arcuate POMC neurons mediates this suppression, but direct inhibitory action of CRH is also suggested [25].

Most striking has been the ability of interleukin-6 to acutely and chronically activate the HPA axis in humans [117]. It is not clear,however, which of the above effects are endocrine and which are paracrine. Presence of cytokinergic neural pathways and local involvement of eicosanoids and PAF in CRH secretion are certain. Finally,indirect activation of the HPA axis is also mediated through cytokine induced stimulation of the central noradrenergic stress system. Conversely,activation of the HPA axis has profound inhibitory effects on the inflammatory immune response, because virtually all the components of the immune response are inhibited by cortisol (Fig.

Tsigos C, Chrousos GP (1994) Physiology of the hypothalamic-pituitary-adrenal axis in health and dysregulation in psychiatric and autoimmune disorders. Endocrinol Metab Clin North Am 23:451–466 115. Tsigos C, Crosby SR, Gibson S, et al (1993) Proopiomelanocortin is the predominant ACTH related peptide in human cerebrospinal fluid. J Clin Endocrinol Metab 76:620–624 116. Tsigos C, Kyrou I, Chala E, Tsapogas P, Stavridis JC, Raptis SA, Katsilambros N (1999) Circulating tumor necrosis factor alpha concentrations are higher in abdominal versus peripheral obesity.

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