hey guys
we were talking about meeting this sem or at least posting our stuff here 2. just want to get the ball rolling and see if anyone is still interested. The best option might be to post our stuff and ask each other questions on the blog. we could have a facilitator for each week who might ask most of the questions and then write a condensed report. It's then possible for everyone to read the blog at any time and actually see the questions being asked and answered, and this will go on for some time for each topic so it's like a continual revision cycle thing-o. I'll volunteer for first and second week if anyone else wants to hop on the bandwagon.
Cheers
Pat
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Here's what I did for Week 1
Cushing's syndrome
Prognosis and complications
1. Higher mortality due to cardiovascular complications - hypertension, impaired glucose tolerance or diabetes, obesity, hyperlipidemia, coagulopathy, metabolic syndrome/syndrome X. Risk may persist even after Cushing's syndrome is cured.
2. Osteoporosis
3. Psychological and cognitive alterations
4. Reduced GH secretion
5. Gonodal dysfunction
6. Supressed thyroid function
Transsphenoidal surgery for Cushing's disease has a remission rate of 70-80% and recurrence rate of 25% at 10 years. There is a risk of hypopituitarism. 5 year survival rate is 99%. 10 year survival rate is 93%.
Sources
Arnaldi G, Angeli A, Atkinson AB, Bertagna X, Cavagnini F, Chrousos GP, Fava GA, Findling JW, Gaillard RC, Grossman AB, Kola B, Lacroix A, Mancini T, Mantero F, Newell-Price J, Nieman LK, Sonino N, Vance ML, Giustina A, Boscaro M. Diagnosis and complications of Cushing's syndrome: a consensus statement. J Clin Endocrinol Metab. 2003 Dec;88(12):5593-602. PMID: 14671138
Swearingen B, Biller BM, Barker FG, Katznelson L, Grinspoon S, Klibanski A, Zervas NT. Long-term mortality after transsphenoidal surgery for Cushing disease. Ann Intern Med. 1999 May 18;130(10):821-4. PMID: 10366371
robb said...
Endocrine Gland Structure
Pituitary:
The pituitary gland is situated under the hypothalamus in a cavity of the sphenoid bone called the sella turcica. It is divided into two parts, the anterior pituitary (adenohypophysis) and the posterior pituitary (neurohypophysis). There are three sites of hormone production in the pituitary gland.
The first is located in the neurohypophysis and secretes peptides that are synthesized in the neuron bodies of the paraventricular and supra-optic nucleuses of the hypothalamus. These peptides are transported by the axons and released into capillaries.
The second site is in the median eminence, where peptides produced in the hypothalamus are released into the first capillary bed to be transported to the adenohypophysis.
The final site are hormones produced in the adenohypophysis to be released into the second capillary bed and carried around the body.
Neurohypophysis
The neurohypophysis is commonly seen as an extension of the hypothalamus. It consists of two parts, the neural stalk, connecting the body of the gland to the hypothalamus, and the pars nervosa, where the capillary bed from the inferior hypophyseal artery is located. The neurohypophysis consists mainly of neuron axons and cells called pituicytes.
Adenohypophysis
The majority of the adenohypophysis is the pars distalis. The pars distalis is primarily made up of cords of epithelial cells interspersed with capillaries, supported by reticular fibres. Three types of epithelial cells can be distinguished by staining, chromophobes, acidophils and basophils. The acidophils include somatotrophs and lactotrophs. While the basophils consist of gonadotrophs, adrenocorticotrophs and thyrotrophs.
A small section of the adenohypophysis wraps around the infundibulum of the neurohypophysis called the pars tuberalis. This contains mainly gonadotrophs (LH and FSH secreting cells). The final part of the pituitary lies between the pars nervosa and pars distalis and is called the pars intermedia. This is underdeveloped in humans and contains weakly basophilic cells called melanotrophs.
Blood Supply
Two arteries, the inferior and superior hypophyseal, supply the pituitary. The IHA supplies the pars nervosa, producing a capillary bed within the pars nervosa. The SHA supplies initially the neural stalk and a section of neural tissue called the median eminence, which lies on the inferior surface of the hypothalamus, above the pars distalis. Here it forms a capillary bed, which then collects into veins which form a secondary capillary bed in the pars distalis. This system allows peptides from the hypothalamus to be transported by blood to the pars distalis to have stimulatory or inhibitory effects on the hormone secreting cells.
Adrenal Glands:
The adrenal glands are paired organs which lie near the superior pole of the kidneys. They are flattened structures, with a half moon shape. They consist of two distinct layers, an outer yellow layer called the cortex, and an inner reddish-brown layer called the medulla. A dense connective tissue layer covers the cortex and sends trabeculae into the interior of the gland to support the secretory cells. The stroma of the organ consists mainly of reticular fibres.
Blood Supply
The adrenal gland s are supplied by arteries that enter at various points around the periphery and produce three different arteries. Arteries that supply the capsule, cortical arteries that produce a capillary network within the cortex, and medullary arteries which extend directly to the medulla and produce a capillary network. The two capillary networks join to form medullary veins which drain into the suprarenal vein.
Adrenal Cortex
The cells of the adrenal cortex are steroid secreting cells. The cortex can be further divided into three layers.
An outer zona glomerulosa, which occupies 15% of the cortex. It is made up of pyramidal shaped cells organised in closely packed arched cords surrounded by capillaries. These cells are primarily responsible for mineralcorticoid secretion.
The middle layer, making up 65% of the cortex, is called the zona fasciculata. It is organised one or two cell thick cords that run at right angles to the surface of the organ, with capillaries between them. These cells are called spongocytes, and are primarily responsible for glucocorticoid production.
The final layer of the cortex is the zona reticularis, which lies adjacent to the medulla. It is organised into irregular cords that form and anastomosing network.
Adrenal Medulla
The adrenal medulla is composed of polyhedral cells arranged in cords or clumps supported by a reticular fibre network. There is an extensive capillary network around the cords, and a few parasympathetic ganglion cells. The medullary cells are responsible for the secretion of adrenaline and noradrenaline.
Reference:
Junqueira, LC, Carneiro, J, 2005, Basic Histology, McGraw-Hill, 11th edition
I love this idea..i vote we keep it going..thanks for starting it up..
Adrenal glands
Also know as the supra renal glands located above each kidney, made up of
outer cortex and inner medulla. The cortex produces three classes of
steroid hormones:
- Corticosteroid hormones
- Aldosterone hormones
- Androgenic steroids
The medulla produces Adrenaline and Noradrenaline.
The adrenal cortex secretes precursors to androgens such as testosterone.
In sexually-mature males, this source is so much lower than that of the
testes that it is probably of little physiological significance. However,
excessive production of adrenal androgens can cause premature puberty in
young boys.
In females, the adrenal cortex is a major source of androgens. Their
hypersecretion may produce a masculine pattern of body hair and cessation
of menstruation.
Male and female gonads produce steroid sex hormones, identical to those
produced by the renal cortical cells. The major distinction is the source
and relative amounts produced.
Signs & Symptoms:
Symptoms occur because of high cortisol levels over a long period of time.
• Upper body obesity - around the neck, stomach and upper back (buffalo hump), in comparison, arms and legs become very thin
• Round and puffy face, usually with a little redness on the cheeks
• Puffy eyes
• Skin becomes fragile and thin
• Patients bruise easily and heal poorly (leading to infections)
• Purple/pink striae on abdomen, thighs and legs.
• Bones become weak and routine activities can cause aches and pains, particularly backaches.
• Osteoporosis - bones will fracture more easily.
• Peripheral oedema
• Muscle weakness
• Fatigue
• Hypertension
• High glucose levels
• Excess hair growth in women on their face, necks, chest, abdomen and thighs.
• Women usually have irregular or absent menstrual periods
• Mood swings, irritability, anxiety and depression are also common.
• Children tend to be obese and have slow growth rates so are short for their age.
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