Diagnosis and Treatment of Disorders of Sexual Development
FIGURE 119-1. The three stages of normal sexual differentiation. 1, Chromosomal sex is determined by the sex chromosome (X or Y) present in the spermatozoon at fertilization. 2, Gonadal sex…
Endocrinology of Sexual Maturation and Puberty
FIGURE 120-1. Timeline of changes in the reproductive axis. As puberty progresses, there is little change in the frequency of LH pulsations. However, the mass of hormone secreted during each…
Biosynthesis, Processing, and Secretion of the Islet Hormones: Insulin, Islet Amyloid Polypeptide (Amylin), Glucagon, Somatostatin, and Pancreatic Polypeptide
FIGURE 32-1 Amino acid sequence of human and hagfish insulins, with substitutions occurring at each position in 70 other known vertebrate insulins shown below for comparison. Invariant residues are enclosed…
Vitamin D: From Photosynthesis, Metabolism, and Action to Clinical Applications
Hypervitaminosis can occur when pharmaceutical vitamin D is taken in excess, with a wide variety of symptoms and signs related to hypercalciuria, hypercalcemia, and metastatic calcifications (Table 58-2). The toxic…
Management of Diabetes Mellitus in Children
Management of young children with diabetes, especially those younger than 5 years old, must balance opposing risks of hypoglycemia (see section on Hypoglycemia below) and future vascular complications. The relative…
Thyroid Imaging
Technetium-99m (99mTc) in the form of pertechnetate is trapped by the thyroid gland and other sites that concentrate iodide (salivary glands, gastric mucosa), but it is not organified in the…
Malignancy-Associated Hypercalcemia and Medical Management
FIGURE 63-1. Bone biopsy photomicrographs. A, Local osteolytic hypercalcemia secondary to leukemia. Note the presence of leukemic cells in the marrow space and numerous osteoclasts lining the trabecular surface. B,…
Pseudohypoparathyroidism, Albright’s Hereditary Osteodystrophy, and Progressive Osseous Heteroplasia: Disorders Caused by Inactivating GNAS Mutations
FIGURE 65-1. Urinary cyclic adenosine monophosphate (cAMP) excretion in response to an infusion of bovine parathyroid extract (300 USP units). The peak response in normal subjects () and those with…
Surgical Management of Hyperparathyroidism
FIGURE 64-1. Flow diagram for localization strategy in previously unoperated patients. US, Ultrasound. FIGURE 64-2. A, Sestamibi scan showing uptake in thyroid as well as parathyroid tissue. B, Thyroid uptake…
Hormonal Control of Breast Development
FIGURE 123-1. Mammary gland of human female at birth formed by several excretory ducts, ending in terminal ducts. A, Detail of the inset showing the club-shaped terminal end bud from…
