George P. Chrousos – författare

It has been over 50 years since Hans Selye formulated his concept of stress. This came after the isolation of epinephrine and norepinephrine and after the sympathetic system was associated with Walter Cannon's "fight or flight" response. The intervening years have witnessed a number of dis­ coveries that have furthered our understanding of the mechanisms of the stress response. The isolation, identification and manufacture of gluco­ corticoids, the identification and synthesis of ACTH and vasopressin, and the demonstration of hypothalamic regulation of ACTH secretion were pivotal discoveries. The recent identification and synthesis of CRR by Willie Vale and his colleagues gave new impetus to stress research. Several new concepts of stress have developed as a result of advances in bench research. These include the concept of an integrated "stress sys­ tem", the realization that there are bi-directional effects between stress and the immune system, the suggestion that a number of common psychiatric disorders represent dysregulation of systems responding to stress, and the epidemiologic association of stress with the major scourges of humanity.

In Adrenal Disorders, a panel of distinguished physicians and researchers select the most relevant new findings and integrate them into the existing body of clinical knowledge on adrenal pathologies. The book includes important reviews of disturbances in cortisol homeostasis, and new concepts regarding adrenal tumors and hereditary adrenal diseases. Also discussed are mineralocorticoids and the syndromes of mineralocortoid excess and aldosterone synthase deficiency. Authoritative and insightful, Adrenal Disorders provides physicians and scientists with a comprehensive, state-of-the-art practical guide to the devastating diseases of the adrenals that are so often difficult to diagnose and treat.

This volume represents the first attempt to present in one place the clinical syndromes and the pathophysiologic basis for the "resistance states" to each of the classes of steroid hormones. Glucocorticoids, mineralocorticoids, androgens, estrogens, progesterone and vitamin D have widely diverse roles ranging from the control of homeostasis to reproduction and bone formation. They are similar in that they share a chemical structure and that their action is in the cell nucleus where they induce transcription of specific genes leading to synthesis of function-specific proteins. Clinical syndromes of steroid hormone resistance to androgens (complete and partial testicular feminization), aldosterone (pseudo­ hypoaldosteronism) and vitamin D (vitamin D-dependent rickets type II) have been known for many years. Progesterone and glucocorticoid resistance syndromes have been described only recently. Resistance to estrogens has not been reported in man or in animals. It is hoped that a detailed reexamination of what is known about each of these conditions at the clinical and molecular levels will enhance our understanding of the function of these hormones and their mechanisms of action. New insight and research initiatives should result. G.P. Chrousos D.L. Loriaus M.B. Lipsett vii ACKNOWLEDGMENTS The contents of this volume are based in part on the proceedings of an International Conference held in Bethesda in the summer of 1984. This conference was sponsored by the National Institute of Child Health and Human Development, Bethesda, Maryland.

It has been over 50 years since Hans Selye formulated his concept of stress. This came after the isolation of epinephrine and norepinephrine and after the sympathetic system was associated with Walter Cannon's "fight or flight" response. The intervening years have witnessed a number of dis­ coveries that have furthered our understanding of the mechanisms of the stress response. The isolation, identification and manufacture of gluco­ corticoids, the identification and synthesis of ACTH and vasopressin, and the demonstration of hypothalamic regulation of ACTH secretion were pivotal discoveries. The recent identification and synthesis of CRR by Willie Vale and his colleagues gave new impetus to stress research. Several new concepts of stress have developed as a result of advances in bench research. These include the concept of an integrated "stress sys­ tem", the realization that there are bi-directional effects between stress and the immune system, the suggestion that a number of common psychiatric disorders represent dysregulation of systems responding to stress, and the epidemiologic association of stress with the major scourges of humanity.

The entire span of a woman's reproductive years and beyond is the scope of this volume, which presents research covering events from first menstruation through the post-menopausal years. Special care has been taken to balance basic research and clinical information. The volume comprises chapters on first menstruation, hypothalamic amenorrhea, implantation and recurrent abortion, XX metabolic syndrome, endometriosis, menopause, osteoporosis, minimally invasive surgery, assisted reproduction, ultrasound imaging in obstetrics, estrogen receptor modulators, and urogynecology. Papers on fertility drugs and gynecologic cancer, contraception today, prenatal genetic diagnosis, cloning and stem cells, transdermal hormone therapy, and estrogen and brain function will also be included.Authors from the International Federation of Gynecology and Obstetrics will address issues such as, Is there an optimal rate for cesarean section? and fistulas in Africa, as well as perinatal mortality in Europe.This volume is the latest proceedings of a series of meetings that has been held in Athens for over a decade, and the participants are internationally known authorities in their fields.NOTE: Annals volumes are available for sale as individual books or as a journal. For information on institutional journal subscriptions, please visit www.blackwellpublishing.com/nyas.ACADEMY MEMBERS: Please contact the New York Academy of Sciences directly to place your order (www.nyas.org). Members of the New York Academy of Science receive full-text access to the Annals online and discounts on print volumes. Please visit http://www.nyas.org/MemberCenter/Join.aspx for more information about becoming a member

Crosstalk between the neuroendocrine and immune systems plays an essential role in inflammatory, autoimmune, and allergic diseases. An international group of scientists from the fields of neurobiology, neuroendocrinology, immunology, and behavioral sciences reports here on recent advances in our understanding of the communication and modulation taking place between the neuroendocrine and immunological systems. In an effort to incorporate all recent knowledge in this field, broad aspects of endocrinology and neuropsychiatric and autoimmune disorders is included, with special attention given to recent progress in molecular biology and genetics. In particular, the volume focuses on diseases of the nervous system and their modulation by the immune and endocrine systems, as well as on the neuroimmunomodulation of inflammatory, autoimmune, and allergic diseases with an emphasis on the female gender. Special care has been taken by the editors to balance basic and clinical information. The volume is divided into sections: the cytokine and neuropeptide signal transduction systems and their immunomodulatory properties, the neuroendocrine immune basis of rheumatic disease, models of inflammation, the immunology of neuropsychiatric and allergic disorders, neuroendocrine and autoimmune adaptations in aging, neuroimmune interactions in chronic pain disorders and infectious diseases, and finally a structural and functional overview of the stress system. Clinical applications have been extrapolated from the basic knowledge and physiology of neuroimmune interactions, so this volume will provide a useful update for both researchers and clinicians. NOTE: Annals volumes are available for sale as individual books or as a journal. For information on institutional journal subscriptions, please visit www.blackwellpublishing.com/nyas.ACADEMY MEMBERS: Please contact the New York Academy of Sciences directly to place your order (www.nyas.org). Members of the New York Academy of Science receive full-text access to the Annals online and discounts on print volumes. Please visit http://www.nyas.org/MemberCenter/Join.aspx for more information about becoming a member

The mysteries of stress and its bodily effects revive old challenges and provide us with new ones. The Björntorp Symposium, which is recorded in this volume, focused on the role of stress and the brain in the pathologic conditions of obesity and metabolic syndrome, including in their physiology, pathophysiology, socioeconomic consequences, and therapeutic interventions. Special emphasis was placed on the metabolic consequences of stress, which might contribute to the alarming increase in the prevalence of obesity and its comorbidities in recent years. The symposium and this volume are dedicated to the memory of a distinguished physician scientist, Professor Per Björntorp, whose pioneering ideas and research have set the foundations in this important field and continue to be a source of inspiration.NOTE: Annals volumes are available for sale as individual books or as a journal. For information on institutional journal subscriptions, please visit http://www.blackwellpublishing.com/nyas.ACADEMY MEMBERS: Please contact the New York Academy of Sciences directly to place your order (http://www.nyas.org/). Members of the New York Academy of Science receive full-text access to the Annals online and discounts on print volumes. Please visit http://www.nyas.org/MemberCenter/Join.aspx for more information about becoming a member

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.

In Adrenal Disorders, a panel of distinguished physicians and researchers select the most relevant new findings and integrate them into the existing body of clinical knowledge on adrenal pathologies. The book includes important reviews of disturbances in cortisol homeostasis, and new concepts regarding adrenal tumors and hereditary adrenal diseases. Also discussed are mineralocorticoids and the syndromes of mineralocortoid excess and aldosterone synthase deficiency. Authoritative and insightful, Adrenal Disorders provides physicians and scientists with a comprehensive, state-of-the-art practical guide to the devastating diseases of the adrenals that are so often difficult to diagnose and treat.

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.