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The Pituitary
5th Edition - May 20, 2022
Editor: Shlomo Melmed
Hardback ISBN:9780323998994
9 7 8 - 0 - 3 2 3 - 9 9 8 9 9 - 4
eBook ISBN:9780323985338
9 7 8 - 0 - 3 2 3 - 9 8 5 3 3 - 8
The Pituitary, Fifth Edition continues the tradition of a cogent blend of basic science and clinical medicine. The comprehensive text written by expert pituitary scholars is… Read more
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The Pituitary, Fifth Edition continues the tradition of a cogent blend of basic science and clinical medicine. The comprehensive text written by expert pituitary scholars is devoted to the pathogenesis, diagnosis and treatment of pituitary disorders. The new fifth edition has been extensively revised to reflect the most recent data on new research advances in tumorigenesis and new therapeutic approaches for pituitary tumors, particularly in acromegaly and Cushing disease. Notably, new chapters devoted to the Pituitary-Immune Interface and Pituitary Radiotherapy have been included, along with a chapter on Aggressive Pituitary Adenomas developed to align with the WHOs Classification of Pituitary Tumors.
Furthermore, new authors have been invited, ensuring a fresh perspective on critical issues in the field. This extensive body of knowledge is useful for students, trainees, physicians, and scientists who need to understand critical pituitary functions and how to care for patients with pituitary disorders.
Provides a detailed description of the wide spectrum of clinical disorders emanating from the dysfunction of the “master gland” and the fundamental science underlying pituitary dysfunction
Brings together pituitary experts from all areas of research and practice who take readers all the way from bench research to genomic and proteomic analysis, clinical analysis, and new therapeutic approaches
Describes the mechanisms for disease pathogenesis, including both subcellular and extrinsic mechanisms that subserve normal and disordered pituitary hormone secretion and action
Researchers, practitioners, and graduate students in endocrinology and researchers of endocrine diseases across biomedical disciplines, as well as those working with endocrinologists such as neurosurgeons and OB/GYNs
Cover image
Title page
Table of Contents
Copyright
Dedication
List of contributors
Preface
Section I. Hypothalamic—Pituitary Function
Chapter 1. Pituitary Development
The pituitary gland
Formation of Rathke's pouch
Glandular or endocrine gland development
Vascular development
Signals controlling pituitary development
Cell differentiation
Tissue architecture and cell networks
Pituitary cell cycle control
Progenitors and stem cells
Corticotrophs
Melanotrophs
Gonadotrophs
Somatotrophs
Lactotroph differentiation
Thyrotrophs
Perspectives
Chapter 2. Hypothalamic Regulation of Anterior Pituitary Function
Introduction
Anatomy and histology of the hypothalamic–pituitary unit
Cellular composition of the anterior pituitary
Hypothalamic factors regulating anterior pituitary function
Hypothalamic prolactin regulators
Summary
Chapter 3. Adrenocorticotrophin
Corticotroph biology
Proopiomelanocortin gene
Regulation of the HPA axis
Effects of secreted Pomc-derived peptides in physiology and disease
Measurement assays for ACTH
Chapter 4. Growth Hormone
Introduction
Growth hormone gene
GH synthesis
Hypothalamic hormones
GH action
GH and metabolism
GH and reproduction
GH/IGF-1 and cardiovascular function
GH effects on renal function
Tests of GH secretion
Clinical use of GH
GH replacement in adults
Side effects of GH replacement
GH replacement and hypopituitarism
GH replacement in acromegaly
GH in the healthy elderly
GH abuse by athletes
Chapter 5. Prolactin
Introduction
Ontogeny of lactotroph cells
Prolactin biosynthesis
Regulation of prolactin secretion
Physiology of PRL secretion
PRL receptors
PRL effects on target tissues
Drugs and chemicals interfering with prolactin synthesis and action
Biochemical evaluation of PRL secretion
Chapter 6. Thyroid-Stimulating Hormone
Introduction
History of the discovery of TSH
Ontogeny of thyrotroph cells
TSH subunit genes
TSH biosynthesis
Regulation of TSH biosynthesis
TSH secretion
Regulation of TSH secretion
Other regulators of TSH biosynthesis and secretion
TSH ACTION
TSH measurement
Disorders of TSH production
Chapter 7. Gonadotrophin Hormones
Introduction
Development, embryology, and histology
Biochemical structure and molecular biology of LH and FSH
Ontogeny and physiology of LH and FSH secretion
Biologic functions of LH and FSH
Assay systems for measurement of gonadotrophins
Hypothalamic regulation of LH and FSH
Feedback regulation of LH and FSH secretion
Molecular biology of LH and FSH subunit genes
Diagnostic tests
Clinical disorders affecting the gonadotroph
Mutations in genes encoding LHβ- and FSHβ-subunits
Acquired hypogonadotrophic disorders
Hypergonadotrophic disorders: excessive or nonphysiologic secretion of gonadotrophins
Treatment of hypogonadotrophic disorders
Chapter 8. The Posterior Pituitary
Neurohypophysis: anatomy and electrophysiology
Vasopressin and oxytocin genes
Vasopressin chemistry, processing, and metabolism
Control of vasopressin secretion
Vasopressin receptors and antagonists
Cellular actions of vasopressin
Quantitating renal water excretion
Clinical characteristics of diabetes insipidus disorders
Investigation of polyuria
Radioimmunoassay of AVP, copeptin, and other laboratory determinations
Syndrome of inappropriate secretion of antidiuretic hormone
Signs, symptoms, and treatment of hyponatremia
Section II. Hypothalamic—Pituitary Disorders
Chapter 9. The Hypothalamus
Hypothalamic physiology
Pathophysiology of hypothalamic syndromes
Clinical features of hypothalamic syndromes
Specific hypothalamic disorders
Chapter 10. Anterior Pituitary Failure
Introduction
Etiology
Epidemiology, mortality, and morbidity
Structural causes of pituitary failure
Functional causes of pituitary failure
Clinical manifestations
Diagnostic testing
Treatment of hypopituitarism
Chapter 11. Pituitary-Immune Interface
Immune-regulated hypothalamic and pituitary function
Cytokines and pituitary hormonal regulation
Stress response in the neuroendocrine system
Novel pituitary-directed autoimmunity
Chapter 12. Pituitary Dysfunction in Systemic Disorders
Introduction
Systemic disorders directly affecting the pituitary gland
Nonpituitary tumoral diseases (see also Chapter 22, Nonpituitary Sellar Masses)
Genetic multiglandular tumoral and nontumoral syndromes (see also Chapter 21, Genetics of Pituitary Adenoma Syndromes)
Vascular diseases
Effects of systemic illness on pituitary function
Changes in pituitary morphology and function with aging
Conditions mimicking pituitary disease
Chapter 13. Drugs and Pituitary Function
Introduction
Antineoplastic therapy
Opioids
Drug-induced hyperprolactinemia
Drugs that cause SIADH
Miscellaneous drugs
Chapter 14. The Pituitary Gland in Pregnancy
The pituitary during pregnancy
Pituitary tumors and pregnancy
Nontumoral pituitary disturbances related to pregnancy
Conclusions
Section III. Pituitary Adenomas
Chapter 15. Acromegaly
Introduction
Pathogenesis
Genetic syndromes
Clinical features of acromegaly
Diagnosis
Treatment
Chapter 16. Prolactinoma
Introduction
Classification
Epidemiology and natural history
Pathogenesis
Clinical manifestations
Diagnosis
Treatment
Special situations
Chapter 17. Cushing's Disease
Introduction
Epidemiology
Chronic pituitary ACTH and proopiomelanocortin peptide oversecretion
Adrenal pathology in Cushing's disease
ACTH-dependent spontaneous Cushing's syndromes
ACTH-independent spontaneous Cushing's syndrome
Iatrogenic Cushing's syndromes
Clinical features
Diagnosis of Cushing's disease
Long-term outcomes of Cushing's disease
Diagnostic approach
Imaging
Pitfalls in diagnosis
Treatment
Pituitary surgery and radiation
Medical treatments
Adrenal surgery
Overall approach for treatment
Chapter 18. Nonfunctioning and Gonadotrophin-Secreting Adenomas
Predictive markers and potential factors implicated in aggressiveness
Current and emerging therapeutic approaches
Conclusions
Chapter 21. Genetics of Pituitary Adenoma Syndromes
Introduction
Syndromic conditions associated with pituitary adenomas
Genetic forms of isolated pituitary adenomas
Genetic testing overview
Chapter 22. Nonpituitary Sellar Masses
Introduction
Clinical diagnosis
Imaging diagnosis
Morphological diagnosis
Specific lesions
Conclusions
Section IV. Pituitary Procedures
Chapter 23. Pituitary Imaging
Introduction
Imaging techniques
Imaging of pituitary adenomas
Imaging of other sellar and parasellar masses and pathologies
Chapter 24. Pituitary Surgery
Introduction
Historical overview
Diagnostic evaluation
Surgical anatomy
Surgical techniques
Transcranial approach
Complications
Selecting the correct surgical approach
Further treatment
Approach to pituitary tumors based on specific type
Evolving technologies
Conclusions
Chapter 25. Radiotherapy in the Management of Pituitary Adenomas
Background
Radiotherapy techniques
Nonfunctioning adenomas
Functioning adenomas
Future directions
Index
No. of pages: 790
Language: English
Published: May 20, 2022
Imprint: Academic Press
Hardback ISBN: 9780323998994
eBook ISBN: 9780323985338
SM
Shlomo Melmed
Shlomo Melmed, MB, ChB, FRCP, MACP, is Executive VP and Dean of the Medical Faculty at Cedars-Sinai Medical Center. He leads Cedars-Sinai’s research and education programs, recruiting nationally recognized faculty leadership, establishing new educational programs and maintaining the highest academic standards. Dr. Melmed holds the Helene A. and Philip E. Hixon Distinguished Chair in Investigative Medicine. An international authority on pituitary medicine, he has pioneered the discovery and application of novel treatments for endocrine tumors and has authored more than 350 peer-reviewed articles.
Dr. Melmed has been a faculty leader at Cedars-Sinai for nearly 40 years and has been the health system’s chief academic officer since 1998. Dr. Melmed's laboratory consistently has received competitive grant awards from the National Institutes of Health since 1980, and he has trained over 80 physicians, scientists and graduate students who occupy leading positions in academic endocrinology worldwide. He is on the editorial board of the Journal of Clinical Investigation and is also an Associate Dean of the UCLA School of Medicine.
Affiliations and expertise
Professor of Medicine, Dean of the Medical Faculty, Cedars Sinai Health System, USA