By Dimitrios Linos (Editor), Jon A. van Heerden (Editor)

- Over two hundred beautiful illustrations, starting from intraoperative photos, line drawings, diagnostic pictures, pathology slides, tables and graphs can be found to make each one case mentioned understandable and straightforward to follow.  - conventional and novel ther

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Extra resources for Adrenal Glands: Diagnostic Aspects and Surgical Therapy

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Episodic bursts of secretion appear throughout the day [58, 128]. The central mechanisms responsible for the circadian release of CRH/AVP/ ACTH in their characteristic pulsatile manner are not completely defined, but appear to be controlled by one or more central pacemakers [37]. Plasma cortisol concentrations generally follow those of ACTH, but owing to differences in bioavailability and pharmacokinetics between the two hormones, the correlation between their plasma concentrations is not perfect [54, 130].

12. Anatomical relationships of the right adrenal gland during an open surgical approach. (After [14a, plate 333]) bursa) and stomach [2]. The posterior surface is divided into upper and lower areas via a curved transverse ridge: its upper area, slightly convex, rests on the diaphragm, while the lower concave area contacts the superior pole and adjacent anterior surface of the right kidney. The medial border contacts,and may extend posteriorly towards, the inferior vena cava and is sometimes tucked behind it [10, 18].

2 Growth Axis Growth is also sacrificed in order to preserve homeostasis under stressful conditions through a variety of inhibitory effects mediated by the HPA axis (Fig. Prolonged activation of the HPA axis results in increased circulating levels of glucocorticoids which suppress the secretion of growth hormone (GH) and inhibit the action of somatomedin C and other growth factors on their target tissues [15, 122, 57]. However, it should be noted that at the onset of the stress response or after acute administration of glucocorticoids an acute elevation of growth hormone concentration in plasma may occur, presumably as a result of GH gene stimulation by glucocorticoids through glucocorticoid-responsive elements in its promoter region [19].

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