Pituitary (eBook)

eBook Download: PDF | EPUB

2010 | 3. Auflage
744 Seiten
Elsevier Science (Verlag)
978-0-12-380927-8 (ISBN)

The pituitary, albeit a small gland, is known as the 'master gland' of the endocrine system and contributes to a wide spectrum of disorders, diseases, and syndromes. Since the publication of the second edition of The Pituitary, in 2002, there have been major advances in the molecular biology research of pituitary hormone production and action and there is now a better understanding of the pathogenesis of pituitary tumors and clinical syndromes resulting in perturbation of pituitary function. There have also been major advances in the clinical management of pituitary disorders. Medical researchers and practitioners now better understand the morbidity and mortality associated with pituitary hormone hyposecretion and hypersecretion. Newly developed drugs, and improved methods of delivering established drugs, are allowing better medical management of acromegaly and prolactinoma. These developments have improved the worldwide consensus around the definition of a 'cure' for pituitary disease, especially hormone hypersecretion, and hence will improve the success or lack of success of various forms of therapy. It is therefore time for a new edition of The Pituitary. The third edition will continue to be divided into sections that summarize normal hypothalamic-pituitary development and function, hypothalamic-pituitary failure, and pituitary tumors; additional sections will describe pituitary disease in systemic disorders and diagnostic procedures, including imaging, assessment of the eyes, and biochemical testing. The first chapter will be completely new - placing a much greater emphasis on physiology and pathogenesis. Two new chapters will be added on the Radiation and Non-surgical Management of the Pituitary and Other Pituitary Lesions. Other chapters will be completely updated and many new author teams will be invited. The second edition published in 2002 and there have been incredible changes in both the research and clinical aspects of the pituitary over the past 8 years - from new advances in growth hormones to pituitary tumor therapy. - Presents a comprehensive, translational source of information about the pituitary in one reference work - Pituitary experts (from all areas of research and practice) take readers from the bench research (cellular and molecular mechanism), through genomic and proteomic analysis, all the way to clinical analysis (histopathology and imaging) and new therapeutic approaches - Clear presentation by endocrine researchers of the cellular and molecular mechanisms underlying pituitary hormones and growth factors as well as new techniques used in detecting lesions (within the organ) and other systemic disorders - Clear presentation by endocrinologists and neuroendocrine surgeons of how imaging, assessment of the eyes, and biochemical testing can lead to new therapeutic approaches

The pituitary, albeit a small gland, is known as the "e;master gland"e; of the endocrine system and contributes to a wide spectrum of disorders, diseases, and syndromes. Since the publication of the second edition of The Pituitary, in 2002, there have been major advances in the molecular biology research of pituitary hormone production and action and there is now a better understanding of the pathogenesis of pituitary tumors and clinical syndromes resulting in perturbation of pituitary function. There have also been major advances in the clinical management of pituitary disorders. Medical researchers and practitioners now better understand the morbidity and mortality associated with pituitary hormone hyposecretion and hypersecretion. Newly developed drugs, and improved methods of delivering established drugs, are allowing better medical management of acromegaly and prolactinoma. These developments have improved the worldwide consensus around the definition of a "e;cure"e; for pituitary disease, especially hormone hypersecretion, and hence will improve the success or lack of success of various forms of therapy. It is therefore time for a new edition of The Pituitary. The third edition will continue to be divided into sections that summarize normal hypothalamic-pituitary development and function, hypothalamic-pituitary failure, and pituitary tumors; additional sections will describe pituitary disease in systemic disorders and diagnostic procedures, including imaging, assessment of the eyes, and biochemical testing. The first chapter will be completely new placing a much greater emphasis on physiology and pathogenesis. Two new chapters will be added on the Radiation and Non-surgical Management of the Pituitary and Other Pituitary Lesions. Other chapters will be completely updated and many new author teams will be invited. The second edition published in 2002 and there have been incredible changes in both the research and clinical aspects of the pituitary over the past 8 years from new advances in growth hormones to pituitary tumor therapy. - Presents a comprehensive, translational source of information about the pituitary in one reference work- Pituitary experts (from all areas of research and practice) take readers from the bench research (cellular and molecular mechanism), through genomic and proteomic analysis, all the way to clinical analysis (histopathology and imaging) and new therapeutic approaches- Clear presentation by endocrine researchers of the cellular and molecular mechanisms underlying pituitary hormones and growth factors as well as new techniques used in detecting lesions (within the organ) and other systemic disorders- Clear presentation by endocrinologists and neuroendocrine surgeons of how imaging, assessment of the eyes, and biochemical testing can lead to new therapeutic approaches

Front Cover 1
The Pituitary 4
Copyright 5
Dedication 6
Contents 8
Contributors 10
Preface 12
Section I - Hypothalamic-Pituitary Function 14
Chapter 1 Pituitary Development 16
The Pituitary Gland 16
Formation of Rathke’s Pouch 16
Glandular or Endocrine Gland Development 18
Signals Controlling Pituitary Development 18
Progenitors and Stem Cells 20
Cell Differentiation 20
Pituitary Cell Cycle Control 22
Postnatal Development 23
Corticotropes 23
Melanotropes 24
Gonadotropes 24
Somatotropes 25
Lactotrope Differentiation 25
Thyrotropes 26
Perspectives 26
References 27
Chapter 2 Hypothalamic Regulation of Anterior Pituitary Function 34
Anatomy and Histology of the Hypothalamic-pituitary Unit 35
Hypothalamic Factors Regulating Pituitary Function 38
Summary 54
References 54
Chapter 3 Adrenocorticotropin 60
Cells of Origin 60
Molecular Embryology 61
Localization of non-ACTH Peptides Within Corticotrophs 62
Extrapituitary Localization of Acth and Related Peptides 63
Gene Structure 63
Gene Regulation 65
POMC Biosynthesis and Processing 66
Hormone Measurement 69
Secretion of ACTH: Physiology 81
HPA-axis–immune Interactions 85
References 88
Chapter 4 Growth Hormone 96
Growth Hormone (GH) Gene Structure 96
Control of GH Secretion 98
Hypothalamic Hormones 100
GH and Metabolism 108
Tests of GH Secretion 109
Clinical use of GH (Table 4.4) 113
References 122
Chapter 5 Prolactin 132
Historical Overview 132
Cell of origin 132
Prolactin Gene 133
Hormone Biosynthesis 138
Hormone Secretion: Biochemistry 140
Neuroendocrine Regulation 144
Prolactin Action 149
Pathologic states of prolactin secretion 159
References 163
Chapter 6 Thyroid-stimulating Hormone 180
Introduction 180
Ontogeny of Thyrotrope Cells 180
TSH Subunit Genes 182
Biosynthesis of TSH 185
Regulation of TSH Biosynthesis 188
TSH Secretion 192
Regulation of TSH Secretion 194
Action of TSH 196
TSH Measurements 200
Disorders of TSH Production 202
References 205
Chapter 7 Gonadotropin Hormones 218
Introduction 218
Development, Embryology and Histology 218
Biochemical Structure and Molecular Biology of LH and FSH 221
Ontogeny and Physiology of LH and FSH Secretion 225
Biologic Functions of LH and FSH 229
Assay Systems for the Measurement of Gonadotropins 232
Hypothalamic Regulation of LH and FSH Secretion 234
Feedback Regulation of LH and FSH Secretion 240
Molecular Biology of LH and FSH Subunit Genes 245
Diagnostic Tests 249
Clinical Disorders Affecting the Gonadotrope 250
Treatment of Hypogonadotropic Disorders 260
References 264
Chapter 8 The Posterior Pituitary 274
Structure of the Neurohypophysis: Anatomy and Electrophysiology of Vasopressin-producing Cells 274
The Vasopressin and Oxytocin Genes 275
Chemistry, Processing and Metabolism of AVP 278
Central Nervous System Mediators of Vasopressin and Oxytocin Release 279
Control of AVP Secretion 280
Vasopressin Receptors and Antagonists 285
Cellular Actions of Vasopressin 286
Quantitating Renal Water Excretion 288
Clinical Characteristics of Diabetes Insipidus Disorders 288
Investigation of a Patient With Polyuria 295
Radioimmunoassay of AVP and Other Laboratory Determinations 298
Syndrome of Inappropriate Secretion of the Antidiuretic Hormone (SIADH) 300
Signs, Symptoms and Treatment of Hyponatremia 302
References 303
Section II - Hypothalamic-Pituitary Disorders 314
Chapter 9 The Hypothalamus 316
Anatomy 316
Hypothalamic Functions 316
Pathophysiological Principles 320
Manifestations of Hypothalamic Disease 323
Neurogenic (Cushing's) Ulcers 331
Disordered Control of Anterior–pituitary Function 332
Specific Hypothalamic Disorders 336
References 348
Chapter 10 Anterior Pituitary Failure 356
Introduction 356
Etiology 356
Mortality 356
Structural Causes of Pituitary Failure 356
Functional Causes of Pituitary Failure 364
Clinical Manifestations 366
Diagnostic Testing 370
Treatment of Hypopituitarism 380
References 386
Chapter 11 Pituitary Function in Systemic Disorders 396
Introduction 396
Disorders Directly Affecting the Pituitary 396
General Effects of Systemic Illness on Pituitary Function 399
Pituitary Alterations in Specific Systemic Disorders 400
References 403
Chapter 12 The Pituitary Gland in Pregnancy and the Puerperium 410
Normal Pregnancy 410
Hormone Secretion 410
Sheehan’s Syndrome 415
Lymphocytic Hypophysitis 416
Prolactinoma 417
Cushing’s Syndrome 417
Acromegaly 418
Tsh-Secreting Tumors 419
Posterior Pituitary Disorders 419
References 420
Chapter 13 Drugs and Pituitary Function 426
Introduction 426
Alcoholic Beverages 426
Smoking 428
Opiates and Opiate Antagonists 429
Cocaine 430
Amphetamines and Methylphenidate 430
Caffeine 430
Benzodiazepines 430
Antidepressants 431
Lithium 431
Antipsychotic Drugs 431
DA Agonists 432
Cholinergic Agonists and Antagonists 432
Antihypertensives 432
Antihistamines 433
Antineoplastic Chemotherapy 433
Estrogens 433
Estrogen Receptor Antagonists and Aromatase Inhibitors 433
Androgens 433
Antiandrogens 434
Glucocorticoids 434
Miscellaneous Drugs 434
References 434
Section III -Pituitary Tumors 444
Chapter 14 Acromegaly 446
Introduction 446
Pathogenesis 447
Extrapituitary Acromegaly 451
Clinical Features of Acromegaly 454
Diagnosis 462
Treatment of Acromegaly 465
References 477
Chapter 15 Prolactinoma 488
Introduction 488
Pathogenesis 490
Clinical Manifestations 500
Diagnosis 502
Treatment 502
Pregnancy in Women With Prolactinomas 520
Other Special Situations 523
References 526
Chapter 16 Cushing's disease 546
Pathophysiology 546
Epidemiology 546
Chronic ACTH and proopiomelanocortin (POMC) peptide oversecretion by the pituitary 547
Effects of chronic ACTH and POMC peptide oversecretion 560
Pathology of the adrenal in Cushing's disease 562
Other causes of Cushing's syndrome 563
Clinical features 566
Description of the condition 566
Diagnosis of Cushing's disease 568
Diagnostic procedures 572
Hormonal evaluation 572
Imaging techniques 583
Pitfalls in diagnosis 585
Strategy 591
Treatment 592
Pituitary-directed therapies 593
Adrenal-directed therapies 598
Nelson's syndrome 602
Strategy 604
Perspectives 605
References 605
Chapter 17 Thyrotropin-Secreting Pituitary Tumors 632
Pathogenesis 632
Pathology 635
Clinical Features 635
Diagnosis 637
Differential Diagnosis 640
Treatment 642
Criteria of Cure and Follow-up 644
Conclusions 644
References 644
Chapter 18 Gonadotroph Adenomas 650
Pathophysiology 650
Pathology 652
Etiology 654
Clinical Presentation 655
Diagnosis 657
Treatment 659
References 663
Chapter 19 Nonpituitary Tumors of the Sellar Region 668
Ectopias 668
Hamartomas 669
Cysts 669
Tumors 671
Hematological Proliferations 679
Metastases 679
Postradiotherapy Tumors 681
Miscellaneous Lesions 681
References 682
Section IV - Pituitary Procedures 688
Chapter 20 Pituitary Imaging 690
History of Pituitary Imaging 690
Plain Films and Tomograms 691
Angiography 691
CT 691
MRI: Technique and Anatomy 694
Pituitary Size and Shape 697
Microadenomas 699
Macroadenomas 701
Posterior Pituitary 704
Other Intrasellar/Suprasellar Masses 705
Empty Sella 711
References 712
Chapter 21 Pituitary Surgery 716
Historical Overview 716
Diagnostic Evaluation 717
Surgical and Functional Anatomy 718
Surgical Techniques 718
Transsphenoidal Approach 719
Transcranial Pterional Approach 719
Complications 720
Further Treatment 720
Pituitary Tumors 721
Evolving Technologies 729
References 730
Index 734

Erscheint lt. Verlag	9.12.2010
Sprache	englisch
Themenwelt	Medizin / Pharmazie ► Allgemeines / Lexika
	Medizinische Fachgebiete ► Innere Medizin ► Endokrinologie
	Medizin / Pharmazie ► Medizinische Fachgebiete ► Neurologie
	Studium ► 1. Studienabschnitt (Vorklinik) ► Biochemie / Molekularbiologie
	Naturwissenschaften ► Biologie
	Technik
ISBN-10	0-12-380927-4 / 0123809274
ISBN-13	978-0-12-380927-8 / 9780123809278

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