Cliff notes for endocrinology

Endocrine Physiology. Second Editionby Susan P. Porterfield. Mosby, 2001.US$ 32.95 (xiii + 268 pages)ISBN 0 323 01128 4Although not exactly as succinct as the time-honored outlines for undergraduates, in the second edition of Endocrine Physiology, Susan Porterfield concisely covers all of the major endocrinology topics in a mere 286 pages, including anatomical and developmental information about the glands, hormone synthesis and degradation pathways, action at the target cell and relevant clinical presentations. This second edition, like the first, was written as part of a monograph series for medical students to use during their didactic years of training. The purpose of this series appears to be to supplement the standard medical physiology texts that might be lacking in the areas of cardiovascular, renal, gastrointestinal and endocrine physiology content. In addition, the series hopes to make a link between the basic and clinical sciences more apparent for the clinician-to-be.The first chapter provides a clear and concise introduction to the classes of hormones. The description of functions of second messenger systems is quite good and the accompanying figures are even better. However, parenthetical comments that preview upcoming topics and promised additional detail are more distracting and disruptive than helpful. The appendix to this chapter contains a helpful review of gene-expression components. Students reading this book without a strong background in cell biology might have a difficult time with this chapter.Succeeding chapters describe, in order, the pituitary gland (anterior and posterior), the thyroid gland, the endocrine pancreas, endocrine regulation of calcium and phosphate, the adrenal gland, male and female reproductive endocrinology and endocrinology of pregnancy. Where the topic of discussion is a particular endocrine structure, the chapter begins by describing the processes and regulation of development of the structure both anatomically and physiologically. These chapters then go on to describe the production and regulation of release of secretory products and their influences on target cells and tissues. In those chapters where a physiological process is the focus (e.g. calcium/phosphate regulation and pregnancy) the complex interplay of hormonal regulation is described concisely. Typical points of clinical impact of each of the glands, processes and hormones are also described. Some of the chapters are followed by appendices, which provide hormone production rates and experimentally and clinically relevant analytical methods.Several specific items stand out in Porterfield's presentation. She clearly describes the hypophyseal portal system and does a better job at this task than do many texts. The actions of antidiuretic hormone (ADH) on the nephron are reviewed and its role in disorders such as diabetes insipidus and the syndrome of inappropriate secretion of ADH are presented. By contrast, there are no known pathological conditions associated with oxytocin, so only its role in uterine contraction and milk ejection are briefly discussed. The important roles of thyroid hormones in growth, development and metabolic processes are emphasized. The location of the insulin receptor in the cell membrane and the action of glucose transporter molecules in several cell types are well presented, and a flow chart summarizes nicely the physiological effects of insulin deficiency. A more thorough discussion of glucagon than is found in many texts is also provided. An excellent figure that illustrates the derivation of adrenocortical hormones from cholesterol and the enzymes involved in their synthesis is included.However, some items are less well presented. For example, there is only a diagram of proinsulin to accompany the text, and the structures of preproinsulin and active insulin are left to the imagination.The text concludes with three general appendices: a list of commonly used abbreviations in endocrinology and medicine; fairly detailed answers to the self-study questions at the end of each chapter; and an 80-question multiple-choice self-test with answers. The inclusion of this last appendix makes the book an excellent one to use when reviewing for board exams.Several characteristics of this book are particularly pleasing. It clearly and concisely describes hormone physiology in the human body in a way that not only didactic-year medical students should find easy to use, but also that would make it of value to upper-level undergraduates with a strong cell biology background. The figures and photographs are excellent. Each chapter begins by providing learning objectives and concludes with a summary of key points, a list of key words and concepts, self-study questions, and a bibliography that includes other texts and relatively recent papers from endocrinology and physiology journals.Overall, I found this text well written and easy to read. I believe that it is appropriate for several types and levels of students. The reasonable price also will make it attractive for students to purchase as a supplemental text.