By Dimitrios A. Linos, Jon A. van Heerden
- Over two hundred beautiful illustrations, starting from intraoperative images, line drawings, diagnostic photographs, pathology slides, tables and graphs can be found to make each one case mentioned understandable and straightforward to follow.
- conventional and novel healing innovations are introducedand the most recent advancements in minimal-access operative concepts are mentioned and reviewed.
- makes a speciality of a teamwork orientated strategy that identifies the mandatory communications among the various clinical disciplines whilst facing adrenal issues.
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Additional resources for Adrenal Glands Diagnostic Aspects and Surgical Therapy
Glucocorticoids play a key regulatory role on the basal control of HPA axis activity and on the termination of the stress response by acting at suprahypothalamic centers, the hypothalamus, and the pituitary gland [31, 42, 63]. The presence of a direct glucocorticoid negative feedback is crucial for the attenuation of the ACTH secretory response, in order to conserve the capacity of the HPA axis to respond to subsequent stressors. In addition, this negative feedback loop limits the duration of the total tissue exposure to glucocorticoids,thus minimizing the catabolic,antireproductive, and immunosuppressive effects of these hormones.
4. A simplified, schematic representation of the interactions between the hypothalamic-pituitary-adrenal axis and the immune system. Stimulatory effects are represented by solid lines and inhibitory effects by dashed lines (CRH, corticotropin-releasing hormone; ACTH,corticotropin; IL-1,interleukin-1; IL-6, interleukin-6; TNF-a, tumor necrosis factor-a) 23 24 Ioannis Kyrou, Constantine Tsigos endocrine inflammatory cytokines . All three inflammatory cytokines are able to directly and indirectly enhance the synthesis and secretion of CRH and AVP at the level of the hypothalamus and their effects are synergistic [13, 78, 102].
2) [16, 125]. Furthermore, CRH activates an ultra-short negative feedback loop on the CRH neurons , while a similar loop exists in the LC/NE-sympathetic system neurons,with norepinephrine inhibiting its own secretion via collateral branches and inhibitory a2-noradrenergic receptors [1, 41]. In addition, neurotransmitters from parallel neuronal systems, like serotonin, acetylcholine,catecholamines (a1-receptors) and neuropeptide Y, stimulate CRH secretion [18, 44], whereas the GABA/benzodiazepine system and endogenous opioids exert inhibitory effects [17, 82].
Adrenal Glands Diagnostic Aspects and Surgical Therapy by Dimitrios A. Linos, Jon A. van Heerden