Calcium-regulating hormones and cardiovascular function

covered is mom than they need to know about the pituitary. The book is arranged in five major sections. The first section deals with hypothalamic-pituitary function: the seven chapters in this section cover adrenocorticotrophin, GH, prolactin, TSH, FSH and LH, and the posterior pituitary. Most chapters have a common format, beginning with a historical or biochemical review, basic information on normal physiology, and a clinical section specific for each hormone. For example, the chapter on prolactin discusses the myriad causes of hyperprolactinemia, and the chapter on TSH goes into depth on the thyroid hormone resistance syndromes. Clinical testing and diagnostic procedures are carefully described. The refinement in TSH assays, with continued improvement in separating euthyroid patients from the thyrotoxic patients, is discussed. The second major section deals with hypothalamic-pituitary dysfunction and discusses specific diseases, such as the

Prader-Willi syndrome and Wolfram syndrome. Both of these disorders are covered in more detail under other sections as well. Anterior pituitary failure and provocative tests for defining pituitary responsiveness are reviewed. The third section has chapters on acromegaly, hyperprolactinemia, Cushing’s disease, the rare pituitary TSH-secreting tumors, and gonadotrophin adenomas. The fourth section is entitled “Pituitary Disease in Systemic Disorders” and has chapters on a wide range of topics. Many, if not most, medical disorders influence pituitary function. AIDS patients, with or without pituitary infection by opportunistic pathogens, have been shown to have impaired pituitary function. Other disorders, such as metastatic cancer and pituitary tumors as part of multiple endocrine neoplasia, am covered. Aging, pregnancy, eating disorders, and many drugs also affect the pituitary. These alterations and implications are extensively and completely considered.

The final section deals with diagnostic procedures. Pituitary imaging and the merits of magnetic resonance imaging (MRI) versus computed tomography (CT) are discussed, with the author joining others in strongly endorsing MRI as the best, and perhaps only, imaging technique for pituitary visualization. Vision and visual field defects are also included, and the book ends a section on evaluation of normal pituitary function using the standard stimulation tests. This book is well written and edited and, although not a text for the medical student or generalist, the serious endocrinologist will find the book helpful for reference. It complements nicely the new edition of Endocrinology and Metabolism . TEM Lewis B. Morrow

Department of Medicine Medical College of Ohio Toledo, Ohio 43699-0008, USA SSDI 1043-2760(95)00108-T

Nonclassic Calcium Regulation Calcium-Regulating Hormones and Cardiovascular Function Edited by M.F. Crass, III and Louis V. Avioli. Boca Raton, CRC, 1995, $119.95 USA, $144.00 elsewhere (330 pages), ISBN O-84938-661-6. Most endocrinologists are familiar with the classic actions of parathyroid hormone, calcitonin, and vitamin D. They are the crux of bone and mineral metabolism. However, this book deals with a whole area of nonclassic actions of hormones on the cardiovascular system. Of the 13 chapters, all except two concentrate upon the vascular actions of the calcium-regulating factors on cardiovascular function, and the other two chapters deal with the actions of estrogen, progesterone, and insulin. The introductory chapter provides a lengthy review of the classic actions of TEM Vol. 6, No. 7, 1995

these hormones and then briefly introduces the nonclassic action. The next three chapters are devoted to the actions of the parathyroid hormone on vascular and cardiac activity, the physiology of cardiac cells, and blood pressure regulation. Parathyroid hormone dilates blood vessels and has varying effects on regional blood flow. For example, it increases the flow in coronary, adrenal, and renal vessels and has little direct effect on skeletal and mesenteric vascular beds. Studies show enhanced contractility and heart rate with administration. The hypotensive effect of parathyroid hormone noted is a paradoxical observation-given the hypertensive state noted in clinical hyperparathyroidism. This apparent contradiction is now resolved by the finding of a novel hypertensive factor secreted by the parathyroid gland. An entire chapter is devoted to a discussion of this substance. It’s probably a protein, can be bound by specific antibodies, and is secreted by a

81995,

Ekevier Science Inc., 1043-276Ot95/$9.50

unique group of cells within the pamthyroid glands. Like pamthyroid hormone, calcium regulates its secretion. Its role in human physiology is unclear. It may potentate the effects of endogenous vasoconstrictors and thereby maintain vascular tone in states of hypotension or shock. A final chapter details the knowledge about the customary actions of parathyroid hormone-related protein and its potential influence on vascular activity and its role as a local regulatory agent in regional cardiovascular function. The next three chapters describe the physiology of vitamin D, with most attention on its vascular actions-effects on calcium transport in vascular smooth muscle cells and its trophic effect on vascular and cardiac cells. Four brief chapters cover the epidemiology of cardiovascular disease as related to vitamin D physiology, the vasodilatory, chronotropic, and inotropic actions of calcitonin gene-related peptide, activities of estrogen and progesterone on cardiac

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function, and the effect of insulin and calcium-magnesium metabolism on cardiovascular disease. The final chapter succinctly summarizes the clinical issues of calcium-regulating hormones in human hypertension and ties together a great deal of information in the previous chapter with the renin-aldosterone system and blood pressure homeostasis. The book is easily readable, even

though it is multiauthored. It has many references, which will provide a good background for anyone seeking more information on a specific topic, and summarizes very concisely information published within the past 15 years. The book is expensive for the casual reader with only a passing interest in the general topic, but reasonably priced for the specialist. For the majority of endocrinolo-

gists, this is a book to remember for future reference as the now nonclassic effects of the calcium-regulating hormone become more familiar and of relevance to clinical practice. TBM Angelo A. Licata Department of Endocrinology The Cleveland Clinic Foundation Cleveland, OH 44195, USA SSDI 1043-2760(95)00107-S

Life and Death of the Beta Cell Molecular Biology of Diabetes. I. Autoimmunity and Genetics; Insulin Synthesis and Secretion Edited by Boris Draznin and Derek LeRoith. Totowa, NJ, Humana Press, 1994, $89.50 (xiii + 404 pages), ISBN O-89603286-8. This book is the first of a two-part series that explores the problems of Type I and Type II diabetes from the viewpoint of the molecular and cell biologist. In this volume, Draznin and LeRoith have put together 16 chapters, which span a variety of “hot topics” in the area of j3 cell function and autoimmunity, particularly as related to Type I diabetes. The chapters are written by individuals who are performing research at the cutting edge of the field. Thus, these chapters provide the reader with not only excellent reviews of many topics, but often some of the best contemporary reviews currently available in the literature. The first section of the book focuses on molecular mechanisms of autoimmunity. In the initial chapter, Pietropaolo and ,Eisenbarth set the high standard that this book attempts to achieve as the authors discuss molecular targets of the autoimmune response in Type I diabetes. Focusing primarily on the question

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of the biochemical nature of the autoantigens of ,Type I diabetes, the authors present a very up-to-date view of the antigens that have been identified, the molecular relationship of these antigens to environmental antigens, and their possible role in molecular mimicry, as well as the usefulness of these various antibodies in prediction of the develop ment of Type I diabetes. In view of the rapidity with which these antibody assays are becoming commercialized and available for clinical purposes, as well as the recently initiated National Institutes of Health (NIH) study for prevention of Type I diabetes, this information is not only important for the basic and clinical investigators working on Type I diabetes, but also for the clinician faced with the challenges of family screening and desiring the most recent thoughts on immunomodulation and prevention of the disease. Chapter 4, entitled “Pathogenesis of Autoimmune Diabetes,” by Calcinaro et al. forms an excellent mate for this chapter by discussing in much more detail the cellular aspects of the immune response, which are believed to be critical in the development of the p cell destruction. In a somewhat provocative, but always informative, style, Lafferty and his colleagues present and review a number of the important experiments on the cellular basis of the immune distribution of g cells, which have been

01995. Elsevier Science Inc., 1043-2760/95/$9.50

conducted in NOD mice, the most studied animal model of Type I diabetes. The authors also discuss the nature of tissue specificity and possible direct versus indirect models of autoimmune destruction. This sets the stage well for the chapter on pancreatic islet transplantation by Gill, because many of the issues of immune-mediated destruction for the transplanted tissue not only take into consideration the usual immune problems related to allograft and xenografts, but also the special issues that arise in Type I diabetes due to the underlying autoimmune pathology. Gill also presents interesting discussions of many of the problems facing investigators interested in islet cell transplantation from the perspective of tissue availability, tissue compatibility, and approaches to immune modulation. The fourth chapter in this cluster deals with transgenic models of insulin-dependent diabetes mellitus (IDDM). Although transgenic models have provided interesting insights into the nature of the pathogenesis of the immune response, as well as ways to modulate the immune response, this very brief chapter falls a bit short, when compared to the others, in providing a full review of the field and its connections with previous or future studies. The second section of the book deals with molecular and cellular aspects of insulin synthesis and secretion. As such,

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