The Natural Thyroid Diet

Thyroid Factor

Thyroid Factor is a program that was created by Dawn Sylvester to help women deal with thyroid issues. Dawn Sylvester is a 57 years old lady that has worked with 1,000's of real women. She has over the time tried to investigate the underlying reason why majority of women lose energy and also struggle with belly fat and fatigue as they age. It is a comprehensive program thatcomprises of Thyro pause, 11 kinds of thyroid saving foods that will work to help you boost fat burning Free T3. The program also teaches you all the hidden causes of thyroid which are making you fat and later a highly reliable Thyroid reboot plan which is an excellent plan you need to tackle your weight. Additionally, there are tips to reduce bulging fat fast and eventually obtain a healthy body. You also get several bonuses all aimed at helping you solve all the problems that comes with being overweight. The three bonuses you get are 21 Day Thyroid weight loss system, 101 Thyroid boosting foods and Thyroid Jumpstart Guide. Read more here...

Thyroid Factor Summary


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Orbital Adipose Tissue and Thyroid Associated Ophthalmopathy

Thyroid-associated (Graves') ophthalmopathy (TAO) has an autoimmune pathogenesis possibly related to the thyrotropin receptor (50-53). The symptoms of TAO result from inflammation, fibrosis, and accumulation of orbital adipose tissues. Immunohistochemical analysis of orbital tissue biopsies from patients with TAO demonstrates that the thyrotropin receptor is expressed in fibroblast-like cells, accompanied by mast cell infiltrates (50,51). Whether these mast cells, via their fibrogenic (34-36) and or angiogenic (37) potential, may contribute to TAO-associated fibrosis and orbital adipose tissue hypertrophy, respectively, remains to be evaluated. Further, transforming growth factor- inhibits, whereas IL-6 stimulates, thyrotropin receptor expression (52), suggesting that the pathogenesis of TAO may be influenced by competing inhibitory (yin) and stimulatory (yang) adipokine effects within the orbit. One study examined 2686 genes, of which 25 known genes were upregulated in TAO orbital...

What mechanism of action accounts for the inotropic effect of thyroid hormone

Thyroid hormone affects chronic changes in protein synthesis such as alterations of nuclear synthetic machinery, structural changes of the myosin isozyme, and increased expression of p-adrenergic receptors. In addition, more immediate augmentation of contractility results secondary to an increase in mitochondrial respiration and ATP production, enhanced function of sarcolemmal Ca-ATPase, and augmented sodium entry into myocytes. Elevated intracellular sodium levels increase intracellular calcium concentration and activity.

Parathyroid Hormone

Calcitriol Synthesis

Parathyroid hormone (PTH) is secreted by the parathyroid glands, which adhere to the posterior surface of the thyroid gland (see fig. 17.9). These glands release PTH when the blood calcium is too low. A mere 1 drop in the blood calcium level doubles the secretion of PTH.

Thyroid Hormones

Thyroid hormones exert an effect on sebum secretion since thyroidectomy decreases the rate of sebum secretion in rats and administration of thyroxine reverses this effect (140). Increases in sebum secretion rate were observed when thyroxine was given to hypothyroid patients (141), and immunohistochem-ical localization of thyroid hormone nuclear receptors has been demonstrated in human scalp follicles in the nuclei of the outer root sheath cells, dermal papilla cells, sheath cells, and sebaceous gland cells (142). Other than this, little attention has been paid to the effect of thyroid hormones on sebum secretion.

Implications of leptin signal transduction

As mentioned earlier, the fall in leptin during fasting is a potent signal to the brain to increase feeding, reduce energy expenditure, and mediate changes in hormone levels designed to conserve energy (10,17). Low leptin level directly stimulates the expression of NPY and AGRP in the Arc, and indirectly increases MCH in the lateral hypothalamus, leading to hyperphagia and restoration of body weight (10,52). Concurrently, low leptin disinhibits POMC neurons in the Arc, thereby decreasing the synthesis and release of the anorectic peptide a-MSH (10,52). a-MSH normally acts on melanocortin 3 and 4 receptors (MC3 4-R) in the PVN and various hypothalamic nuclei to mediate the satiety effect of leptin (52). a-MSH is antagonized by AGRP, resulting in hyperphagia and weight increase (52). CART, another potent inhibitor of feeding, is directly suppressed by low leptin level during fasting (52). NPY AGRP and POMC CART neurons in the Arc send extensive projections to the PVN, perifornical, and...

AKR mink cell focusinducing virus A

There is often keratitis and nervous symptoms. Epidemiological evidence suggests that infection can be transmitted to cattle from African antelope of the family Bovidae, subfamily Alcelaphinae which includes wildebeest, Connochaetes taurinus and C. gnu, hartebeest, Alcelaphus sp and topi, Damaliscus sp, which may carry the virus as a latent infection. The virus can be transmitted experimentally to cattle and rabbits. There is replication in cell cultures of fetal bovine thyroid, adrenal, kidney, spleen and lung. The virus will also replicate in Vero cells. Synonyms bovine epitheliosis virus bovine herpesvirus 3 malignant catarrhal fever virus Snotsiekte virus wildebeest herpesvirus.

The Glandular System Our Servants Of Secretion

There are dozens of glands, and each of them may be considered an organ specialized for secretion. For example, use your fingers to palpate (PAL-payt) or ''gently touch'' the thyroid (THIGH-royd) gland located on the anterior (front) surface of your neck. The thyroid gland is one type of endocrine (EN-doh-krin) gland - a gland of ''internal'' (endo-) secretion of a hormone (chemical messenger) directly into the bloodstream. Study suggestion Can you name one specific hormone secreted by the thyroid gland Try to answer this question, then check with Chapter 11.

Are there other substances that affect bone development What about hormones

A hormone naturally secreted by the thyroid gland that binds with osteoclasts, making them less active and allows the osteoblasts to form more bone. Secreted by the parathyroid glands (located by the thyroid gland), PTH assists in the regulation of calcium by promoting the absorption of calcium from the intestine and reducing loss of calcium from the urine by the kidney excessive amounts can lead to bone loss. Calcitonin, a hormone naturally secreted by the thyroid gland (located in the neck), binds with the osteoclasts making them less active, which allows the osteoblasts to form more bone. Parathyroid hormone (PTH), secreted by the parathyroid glands (located by the thyroid gland), assists in the regulation of calcium by promoting the absorption of calcium from the intestine and reducing loss of calcium from the urine by the kidney. Interestingly, while PTH is necessary and important at normal levels, excessive amounts can lead to bone loss. Thyroid hormones, secreted by the thyroid...

Discuss the anatomy of the larynx

The larynx, located in adults at cervical levels 4 to 6, protects the entrance of the respiratory tract and allows phonation. It is composed of three unpaired cartilages (thyroid, cricoid, and epiglottis) and three paired cartilages (arytenoid, corniculate, and cuneiform). The thyroid cartilage is the largest and most prominent, forming the anterior and lateral walls. The cricoid cartilage is shaped like a signet ring, faces posteriorly, and is the only complete cartilaginous ring of the laryngotracheal tree. The cricothyroid membrane connects these structures anteriorly. The epiglottis extends superiorly into the hypopharynx and covers the entrance of the larynx during swallowing. The corniculate and cuneiform pairs of cartilages are relatively small and do not figure prominently in the laryngoscopic appearance of the larynx or in its function. The arytenoid cartilages articulate on the posterior aspect of the larynx and are the posterior attachments of the vocal ligaments (or vocal...

Potential Therapeutic Applications

Recent studies suggest that one mechanism by which NPY promotes a state of positive energy balance is through its inhibitory effects on the HPT axis (7,25). Centrally administered NPY to rats decreased circulating levels of the thyroid hormones T3 and T4, and suppressed proTRH mRNA synthesis, thus mimicking the effects of fasting. The actions of NPY on the HPT axis are mediated by hypothalamic Yi and Y5 receptors (26). Consistent with the inhibitory action of NPY on TRH release is the co-localization of GABA-ergic neurons expressing NPY immunoreactivity and TRH-producing neurons in the paraventricular nucleus (27).

Tumor Escape And Future Approaches To Cancer Immunotherapy

Recent progress in tumor immunology has led to novel insights regarding the functions and interactions of immune cells (T, B, NK, M and DC) and the molecules expressed on these cells, which are linked to the development and efficacy of TA-specific immune responses. In addition, a better understanding of the molecular signals and mechanisms involved in the generation of productive immune responses in general has focused attention on those molecular events that occur or do not occur in the tumor microenvironment. The realization that immune cells undergo apoptosis in tumors has led to a search for the mechanism(s) responsible for this death and was instrumental in identifying the TNF family of receptors and ligands as instrumental in mediating tumor-induced apoptosis (165-167). This realization was prefaced by the recognition of the Fas FasL pathway and its role in maintaining the immune privilege at sites such as the anterior chamber of the eye, the brain, the testis or the thyroid...

Cercopithecine herpesvirus 6 CeHV6 An

Unassigned species in the subfamily Alphaherpesvirinae. Genome DNA is 52 G+C. Causes a severe, often fatal, exan-thematous disease in captive vervet monkeys. Antibodies to the virus are rare among monkeys in the wild but the infection spreads rapidly when they are brought together in captivity. Sub-clinical infections are common, but in severe cases there are necrotic hemorrhagic lesions in the lungs, intestine, liver and other organs. Other monkeys, mice and rabbits are resistant to infection. Virus replicates with CPE in vervet monkey kidney cell cultures, also in human thyroid, Vero cells and many other cell lines. Produces no pocks on the CAM and does not kill the embryo. The virus is strongly cell-associated. Antigenically very closely related to Human herpesvirus 3. Synonyms Liverpool vervet monkey virus vervet monkey herpesvirus SA12 virus.

Growth Factors and Neuropeptides

Sebocyte proliferation is stimulated by insulin, thyroid-stimulating hormone, and hydrocortisone (158). In rat preputial cells, growth hormone (GH) increased sebocyte differentiation and was more potent than either insulin-like growth factors (IGFs) or insulin. Furthermore, GH enhanced the effect of DHT on sebocyte differentiation perhaps complementing the effect of androgens in increasing sebum during puberty. IGFs, in contrast, had a greater effect on increasing DNA synthesis compared to GH, and had no effect on the response of the cell to DHT (159), although a role for IGF in causing the observed increase in sebum production at puberty has not been ruled out. This suggests that antagonists of IGF may offer a way of decreasing sebum synthesis.

Retropharyngeal and pretracheal spaces

The retropharyngeal space includes the posterior part of the visceral compartment in which the esophagus, trachea, and thyroid gland are enclosed by the middle layers of deep cervical fasci, which extend into the superior mediastinum. This space may become infected as a result from direct extension of a pharyngeal space infection or through lymphatics from the nasopharynx. The onset of the infection is insidious, although dyspnea, dysphagia, nuchal rigidity, fever, and chills may be present. Bulging of the posterior pharyngeal wall may be present. Soft tissue radiography or computed tomography (CT) scan disclose widening of the retropharyngeal space. Hemorrhage, rupture into the airway, laryngeal spasm, bronchial erosion, and jugular vein thrombosis are the main complications. The pretracheal space that surrounds the trachea generally becomes involved following perforation of the anterior esophageal wall or from an extension of a retropharyngeal infection. Patients usually present...

Angiogenesis Associated with Other Pathological Conditions

Moreover, Sato et al. (186) proposed that VEGF may be responsible for the characteristic hypervascularity of Graves' disease. TSH, insulin phorbol ester, dibutiryl cAMP, and Graves' IgG were found to stimulate VEGF mRNA expression in cultured human thyroid follicles (186).

Depletion of defined cell subsets

Depletion of CD52 positive cells CD52 is expressed on the vast majority of differentiated lymphocytes, monocytes, and macrophages. Alemtuzumab, a humanized antibody against CD52 based on CAM-PATH-1 (Hale et al., 1988), and utilized for lymphoma therapy, leads to a transient but profound depletion of CD52 expressing cells. Interestingly, the analysis of effects on different lymphocyte populations revealed a profound depletion of CD4+ and CD8+ T cells, whereas B cell counts increased. One clinical trial initially showed a positive effect on MRI activity in treated MS patients (Moreau et al., 1994), but one-third of patients developed antibody-mediated autoimmune thyroid disease (Coles et al., 1999). Further monitoring of patients treated with this antibody revealed progressive brain and spinal cord atrophy associated with clinical deterioration, though reduction of inflammatory activity in MRI was sustained (Paolillo et al., 1999). In keeping with these findings, patients in...

How will my clinician use my test results to determine whether I have osteoporosis

A Z-score is usually not helpful in making the diagnosis of osteoporosis. However, if it is particularly low (lower than -1.5), it is important for your clinician to evaluate you for conditions and illnesses that may be causing your bone loss associated with secondary osteoporosis. Such causes of secondary osteoporosis might include thyroid or parathyroid disease, cigarette smoking, excessive alcohol intake, problems with absorption from your gastrointestinal tract, or the use of medications known to be harmful to bone.

Fluorouracil See base analog

Infection is endemic in continental Europe, Asia, Africa and S America, but Australasia, Japan, USA and Canada are free of it. Cattle are the most commonly infected species, but pigs, sheep, goats, deer, elephants and hedgehogs may also be infected. In cattle the disease is not usually fatal but causes loss of condition. There is fever and vesicular eruption in mouth, nose, hooves and udder. There may be myocardial damage. In pigs lameness is the most prominent sign sheep and goats are less severely affected. The disease is extremely contagious. Guinea pigs and suckling mice can be infected experimentally. Virus multiplies in bovine, porcine, ovine and mouse embryo cell cultures. Calf thyroid cell cultures are also often used. There are many subtypes, and more than 40 distinct antigenic strains are recognized. The virus is stable at pH 7.4-7.6 but is inactivated below pH 6. Control is by slaughter in non-endemic regions and by vaccination elsewhere. The vaccine is commonly grown in...

Peroxisome Proliferatoractivated Receptor Genes Structure And Localization

The genomic organization of the members of the nuclear hormone receptors, belonging to the superfamily of steroid thyroid receptors, has provided useful information concerning their degree of relatedness. Their most conserved region contains two zinc fingers that constitute the core of the DNA-binding domain, which specifically recognizes hormone receptor elements. This conservation has been exploited to isolate additional members of the superfamily by sequence analysis, cross-hybridization screening of cDNA libraries, and functional studies. The conserved DNA-binding domain (C-domain) is flanked by a variable N-terminal domain (A B domain) and a C-terminal ligand-binding domain (E F domain), whereby the EF domain is linked with a hinge domain (D-domain) to the DNA-binding domain (Fig. 1). The A B domain contains the activation function 1 (AF-1) that is transcriptionally active in the absence of ligands. The C-domain and

Thyroglossal Duct Cyst

Thyroglossal duct cyst is the commonest congenital mass and is almost always located in the midline (104). This type of cyst results from embryologic anomalies in the descent of the thyroid gland. The thyroid forms high in the neck at the base of the tongue and hyoid bone and, as growth proceeds and the neck enlarges, it descends to the lower part of the neck. If the cyst retains its attachment to the tongue it is called a thyroglossal duct, and any cystic space in this duct is a thyroglossal duct cyst. The duct always joins the base of the tongue by passing behind the hyoid bone, and thus thyroglossal duct cysts are always found below the hyoid bone in the midline or occasionally just to the left of the midline. The cyst moves on swallowing and on protruding the tongue because it is attached to the thyroid gland. The cyst can become infected and cause a tender, red swelling in the midneck. When infected, the cyst is best treated with antibiotics until the acute infection subsides....

Clinical Manifestation Cervicofacial

This is the most common form of actinomycosis (1). The infection is generally odontogenic in origin, and evolves as a chronic or subacute painless or painful soft-tissue swelling or mass involving the submandibular or paramandibular region. However, the submental and retromandibular spaces, tempomandibullar joint and cheek can be involved. The swelling may have ligneous consistency caused by tissue fibrosis. Depending on the composition of the concomitant synergistic flora, the onset of actinomycosis may be acute, subacute, or chronic. When Staphylococcus aureus or beta-hemolytic streptococci are involved, an acute painful abscess or a phlegmatous cellulitis may be the initial manifestation. The chronic form of the disease is characterized by painless infiltration and induration that usually progress to form multiple abscesses and draining sinus tracts discharging pus that may contain sulfur granules in up to 25 of instances. Periapical infection, trismus, fever, pain, and...

Introduction Principle and Advantages of Noncompetitive Immunoassays

Trace characterization of physiologically active substances with a low molecular weight (e.g., steroids, catecholamines, eicosanoids, thyroid hormones, and synthetic drugs) is an important subject in biomedical analyses. Immunoassays are now widely used for this purpose because of their excellent specificity and feasibility and because they exhibit higher sensitivity than other common analytical methods used in this field. Conventionally, such small molecules, which are immunochemically classified as haptens, are determined exclusively with competitive immunoassays. The assay format is based on the competitive reaction between a variable amount of unlabeled hapten (the analytical target, or analyte) and a fixed amount of labeled hapten with a signal-generating group (i.e., radioisotopes, enzymes, or fluorescent and chemiluminescent dyes) against a fixed and limited amount of anti-hapten antibody. Figure 1 illustrates a typical competitive immunoassay procedure using a solid-phase...

Diagnosis Microbiology Issues And Initial Source Control

In circumstances where identifying the site of infection has proven not to be straightforward, an exhaustive systematic workup for possible noninfectious causes of the clinically manifested systemic inflammatory response syndrome should be undertaken. These may include surgery or trauma, venous thrombosis or hematoma, myocardial infarction, pancreatitis, transplant rejection, acute adrenal insufficiency, thyroid storm, malignancy, and others (33).

Signal Transduction via Nuclear Receptors

Finally, a third group of coactivators forms mediator complexes that link transcription factors to the GTF-polymerase complex. An example of a mediator complex is the TRAP DRIP (thyroid hormone receptor-associated protein vitamin D receptor interacting protein) complex. This mediator complex acts as an adaptor that allows transcription factors to communicate with the GTF-polymerase complex. Categorization of coactivators as histone-modifiers, chromatin-remodelers, or mediators is somewhat arbitrary because coactivators can exert multiple functions.

Application Box 41 Development of the Perfect Estrogen

Corepressor proteins mediate inhibitory actions on transcription. For example, in the absence of thyroid hormone, the thyroid-hormone receptor binds to the corepressor molecules nuclear receptor corepres-sor (N-CoR) and silencing mediator of retinoid and thyroid receptors (SMRT). These corepressor proteins attract additional complexes containing histone deacetylase (HDAC) activity. The subsequent removal of acetyl groups from lysines in histones represses transcription by inducing a more compact chromatin conformation.

Nondiabetic endocrine disease i

Describe four steps involved in thyroid hormone synthesis. 1. Uptake of iodide Iodide from the bloodstream is concentrated in thyroid cells by an active transport mechanism. 2. Iodination of thyroglobulin Thyroglobulin, a large glycoprotein rich in tyrosine, is enzymatically iodinated and stored in the thyroid follicles. Approximately 8 mcg of T3 and 90 mcg of T4 are produced daily. Additional T3 is formed from the peripheral conversion ofT4toT3.T3 is approximately four times more potent than T4 but has a much shorter half-life therefore the contribution of each to total thyroid activity is approximately equal. Thyroid-stimulating hormone (TSH) (produced by the anterior pituitary gland) acts on thyroid tissue to increase the rates of all steps involved in thyroid hormone synthesis and release. Thyrotropin-releasing hormone (TRH) (produced by the hypothalamus) in turn regulates the amount of TSH produced by the pituitary. T3 and T4 inhibit release of TSH and to a much smaller degree...

Have early menopause What does this mean for my bones and will I need treatment

A very small percentage of women (1 ) experience natural menopause before the age of 40. It is not known why these people stop having their periods. Idiopathic ovarian insufficiency or premature ovarian failure is a condition that usually occurs in women under the age of 40 and causes menopause. Idiopathic ovarian insufficiency is usually caused by autoimmune and genetic disorders, Addison's disease (disorder of the adrenal glands, which manufacture steroid hormones), or hypothyroidism (an underactive thyroid gland).

AKT pathway inhibitors with an undefined mechanism of action

KP372-1 (26) consists of a 1 1 mixture of indenotetrazolotriazinones, representative of a novel class of fused polycyclic compounds that suppress AKT activity via an unknown mode of action. There have been several reports describing induction of apoptosis and inhibition of cell proliferation by 26 in cancer cells having high levels of AKT activation. For example, 26 induces apoptosis in thyroid cancer cells (NPA187, IC50 30 nM WRO, IC50 60 nM) by blocking the phosphorylation and kinase activity of AKT 39 . Similar findings were observed with 26 in U251 and U87 glioma cells 40 . Compound 26 was also described as a dual AKT PDK1 kinase inhibitor in leukemic cells 41 . Compound

Exclusion of Specific Disorders

As already mentioned, in eumenorrheic women with other hyperandrogenic features, a day 22-24 P4 level, preferably in two consecutive cycles, should be obtained. In patients demonstrating ovula-tory dysfunction, thyroid-stimulating hormone and prolactin levels may also be obtained to exclude thyroid dysfunction and hyperprolactinemia, respectively. The prevalence of these two latter abnormalities among women with hyperandrogenic features is less than 2 (12).

First Taste of Research

In those days before the National Institutes of Health had been founded, only 16 Hopkins medical students in the whole school carried out any research. Without any influence or participation of the faculty, we students met monthly in what we called the Osler Society to discuss our research results among ourselves. My chief interest (and Dr. Richter's) was in endocrinology and its influence on mental functioning and behavior. He had discovered self-selection of food intake in rats, and the effects of electric shock stress on the endocrine system of wild and domesticated rats. He had a contract with the City of Baltimore Health Department to develop an effective rat poison during the war. Among his discoveries was that rats could not taste the poison, alpha-naphthyl thiourea (ANTU), which produced acute pulmonary edema and death in rats. His findings led to its wide use as a rat poison. His observation that ANTU produced hyperpla-sia of the thyroid gland led to the idea and experiments...

Species Differences In Enzyme Induction

There are also species differences in the downstream consequences of enzyme induction. Numerous phenobarbital-type inducers and peroxisomal proliferators are tumor promoting agents in rats, but not in humans. Moreover, prolonged treatment of humans with the anticonvulsants, phenobarbital and phenytoin (human CYP3A4 inducers), does not lead to liver or thyroid tumor formation in humans. Elevation of thyroid stimulating hormone (TSH) in humans does not lead to tumor formation but causes goiter, a reversible enlargement of the thyroid gland treatable with drugs that block thyroid hormone synthesis (86, 87). In contrast, in phenobarbital treated rats, sustained stimulation of the thyroid gland by TSH leads to the development of thyroid follicular tumors. Similarly, chemicals that cause peroxisomal proliferation in rodents do not do so in humans and other primates, possibly because of low levels of PPAR in primate liver (88).

Adverse Effects of Systemic Glucocorticoid Therapy

Osteoporosis, a significant and common adverse effect, is often overlooked secondary to its insidious onset and the insensitivity of conventional diagnostic methods. All patients who have been on more than 7.5 mg prednisone (or equivalent) daily for at least 6 mo are at risk for developing osteoporosis. Trabecular bone (ribs, vertebrae) appears to be more affected by GCs than cortical bone. Factors that increase the likelihood of the development of osteoporosis include inactivity, sex hormone deficiency, a diet deficient in calcium and concurrent use of drugs such as furosemide, anticonvulsants, and excessive thyroid hormone replacement. Because demineralization of bone is not detectable

Management options

In trophoblastic neoplastic disease, uterine evacuation may be adequate surgical management but hysterectomy may be required in more invasive disease, especially in older women. Surgery may also be required for torsion of, or haemorrhage into, ovarian cysts. Chemotherapy maybe required if human chorionic gonadotro-phin levels remain elevated or in metastatic disease. In terms of anaesthetic management, the above considerations should be taken into account and appropriate measures taken regarding investigation (including liver and thyroid function blood tests and chest radiography), monitoring and management. General anaesthesia is usually recommended since uterine bleeding may be rapid and severe, and blood should be cross-matched and ready before surgery.

Multiple Endocrine Neoplasia Type

The bilobate thyroid gland is located on the anterior surface of the trachea at the junction of the larynx and secretes a number of hormones essential for growth and development. Each lobe has many hollow spherical clusters (follicles) that are circumscribed by a single layer of cells. Parafollicular cells (C cells) occupy the spaces between follicles. The follicular cells synthesize and secrete several hormones, including thyroxine and triiodothyronine, which regulate metabolic rate and maintain the responsiveness of the cardiovascular system to nerve impulses. The parafollicular cells manufacture and release calcitonin, which regulates the concentration of calcium ions in the blood and other body fluids. Calcitonin decreases calcium ion concentrations, stimulates the production of bone, reduces the absorption of Ca2+ by the intestine, and stimulates the excretion of Ca2+ by the kidneys. The incidence of both benign and malignant thyroid gland cancers is about 1 in 20,000 individuals...

Behavioral Dysfunction

Classical antipsychotic drugs that potently block dopaminergic receptors can ameliorate psychotic symptoms but worsen parkinsonism, at times seriously enough to require levodopa (84). Better results in treating psychosis have been obtained with the atypical neuroleptics, possibly owing to their predominant antiserotoninergic rather than antidopaminergic activity. An extensive chart review revealed that 90 of DLB patients had partial to complete resolution of psychosis using long-term quetiapine, although in 27 motor worsening was noted at some point during treatment (85). A large, randomized blinded trial found that olanzapine (5 or 10 mg) reduces psychosis without exacerbating parkinsonism (86). Relatively small doses of clozapine have also been used successfully for the relief of paranoid delusions, psychosis, and agitation, albeit at the risk of agranulocytosis (84). Indeed, caution is generally warranted in using neuroleptics, since sedation, confusion, immobility, postural...

Partial Resection of the Submandibular Gland

Face After Submandibular Gland

The submandibular gland derives its blood supply from branches of both the superior thyroid and the facial arteries. Two branches enter it medially and a separate deep perforating branch enters from its deep border. While the function of the gland is dictated by its autonomic input, four critical nerves, the lingual, hypoglossal, marginal mandibular, and cervical, course close to it. The hypoglossal nerve is located posterior to the tendinous junction of the digastric deeper within the neck. The lingual nerve is also deep, protected by the medial border of the mandible,

Gene Mutations in Cancer

Each of these ras family of oncogenes have been found to be mutated with varying frequencies in major forms of human cancer. 1 30 K-ras is mutated in cancers of the lung, colon, and pancreas, as well as in myelodysplastic syndrome and some other cancers (such as seminoma). The frequency of K-ras mutation in pancreatic cancer is estimated to be 90 ,130 suggesting that this gene mutation is very important in the malignant conversion of this tissue. H-ras is mutated in cancers of the bladder, kidney, and thyroid, and N-ras is mutated in seminoma, thyroid, and acute myelogenous leu-kemia.130 In lung cancer, the majority of ras mutations occur in the K-ras gene. 1 31132 K-ras is mutated in 15-20 of all NSCLC and in 30-50 of lung adenocarcinomas,29 131 133-137 but it is infrequently mutated in other lung cancer types.29134 In lung adenocarcinomas, 85 of K-ras mutations affect codon 12. 1 32 Certain carcinogens found in cigarette smoke, such as benzo a pyrene, have been shown to...

Therapeutic Potential Of Dppiv Inhibition

Nervosa and periodontal disease, but are decreased in systemic lupus, rheumatoid arthritis, pregnancy, depression, and schizophrenia (91-98). HIV-infected patients have normal serum DPP-IV activity but with a decreased number of DPP-IV-positive lymphocytes (99). DPP-IV has been employed as a cell surface marker in the histological evaluation of a wide range of tumor types. Tumors have been described with either increased or decreased expression of CD26 DPP-IV, and this divergent expression has been associated with both an increased and decreased aggressiveness of growth of the tumors in question. Tumors with high cell-surface DPP-IV activity expression include B chronic lymphocytic leukemia, basal cell carcinoma, T cell lymphoma, thyroid carcinoma, breast cancer, hepatocellular carcinoma, and lung tumors, while tumors with reduced or absent DPP-IV activity CD26 expression include squamous cell carcinoma and melanoma (88,100108). Presently, it is unclear whether changes in DPP-IV...

Ispinesib and related compounds

Cell Cycle Everolimus

For the combination of ispinesib capecitabine, the DLT and OTR had yet to be defined, although ispinesib had been administered at 18 mg m2 for every 21 days in the combination with capecitabine at 2000 mg m2 daily for 14 of 21 days. One DLT of prolonged (X 5 days) grade 4 neutropenia had been observed at the time of the report. Ispinesib plasma concentrations did not appear to be affected by the presence of capecitabine. A total of eight patients (3 breast, and 1 each of tongue, colorectal cancer (CRC), bladder, thyroid, and salivary gland) had a best response of stable disease (duration 2-6.5 months) 14 .

Pathological Anatomy of Glands What Happens When an Acorn Falls

Sometimes a gland must be ablated (ab-LAYT-ed) or ''taken away'' by surgery. One possible reason for such ablation might be that the gland was destroyed by some terrible accident to the body (auto accident, gunshot wound, and the like). Another reason is gland ablation due to the presence of a malignant (mah-LIG-nant) or ''deadly'' tumor. Cancer of the thyroid gland, for instance, might make thyroidectomy (thigh-royd-EK-toh-mee) -the ''removal of'' (-ectomy) the ''thyroid'' - absolutely necessary for the patient's survival. In such cases of gland ablation or removal, there is likely to be a severe hyposecretion (HIGH-poh-see-KREE-shun) of the gland's hormones. Hyposecretion is a ''deficient or below normal'' (hypo-) ''secretion'' of some substance. After thyroidectomy (ablation or removal of the thyroid), for example, the patient may suffer from a hyposecretion of thyroxine. The resulting disease state is often called hypothyroidism (high-poh-THIGH-royd-izm).

Conclusions and Perspectives

81 Ragno P, Montuori N, Covelli B, Hoyer-Hansen G, Rossi G. Differential expression of a truncated form of the urokinase-type plasminogen-activator receptor in normal and tumor thyroid cells. Cancer Res 1998 58(6) 1315-1319. 91 Montuori N, Rossi G, Ragno P. Cleavage of urokinase receptor regulates its interaction with integrins in thyroid cells. FEBS Lett 1999 460(1) 32-36.

The Molecular Biology of Retinoids and Their Receptors

Pml Rar Alfa Acido Retinoico

In the last several years, the structure and function of nuclear receptors have been determined (6). Based on the similarities among the sequences, it has been possible to classify the receptor superfamilies. The endocrine receptors include the retinoic acid receptors (RARs) and the thyroid hormone receptors, and the adopted orphan thyroid hormone FIGURE 1 Classification of nuclear and orphan receptors. Abbreviations LXR, liver-X-activated receptor PPAR, peroxisomal proliferators activated receptor RXR, retinoid X receptor TR, thyroid hormone receptors, 9cRA, 9-cis-retinoic acid. FIGURE 1 Classification of nuclear and orphan receptors. Abbreviations LXR, liver-X-activated receptor PPAR, peroxisomal proliferators activated receptor RXR, retinoid X receptor TR, thyroid hormone receptors, 9cRA, 9-cis-retinoic acid. FIGURE 3 Schematic overview of coactivator corepressor and histone deacetylase proteins and their functions in chromatin condensation and gene activation. Abbreviations HDAC,...

Medical History and Physical Examination in Patients With Possible Androgen Excess

Polycystic Appearing Ovaries

During the physical exam it will be important to determine whether hirsutism or other hyperandrogenic features are actually present and whether there are signs or symptoms of related disorders. The type and pattern of excessive hair growth and or acne should be noted and scored (Fig. 1). Hirsutism is defined as the presence of terminal hairs in a male-like pattern in women. Clinically, terminal hairs are generally pigmented, coarse (secondary to being medullated), and greater than 1 cm in length (if allowed to grow out). However, excessive terminal hair growth affecting only the lower legs or forearms does not constitute hirsutism, because a mixture of terminal and vellus hairs normally covers these areas. Alternatively, the excessive growth of vellus hairs, producing a fuzzy appearance, is termed vellus hypertrichosis and should not be considered hirsutism. Although a number of medical problems or medications can lead to vellus hypertrichosis, it is more commonly an ethnic variant...

Morphological maturation of basal forebrain cholinergic neurons

The mechanisms of transient hypertrophy of many, if not all, cholinergic neurons are not clear. However, it is possible that trophic factors such as NGF and neurotrophin-3 have a role. In support of this possibility, NGF and NGF mRNA levels in the cerebral cortex reach a peak at P 21 in the rat (Large et al., 1986). In addition, maturation of morphology and cholinergic phenotype are sensitive to thyroid hormone (Gould and Butcher, 1989) and glucocorti-coids (Hu et al., 1996). Loss or decease in these trophic factors and hormones might be responsible for a subsequent decrease in neuronal size and dendritic pruning.

LOH in Benign Diseases

Regions that contain genes suspected in the diseases.79 There are genes implicated in the development and progression of asthma throughout the genome, although the hotspot for alterations via LOH is chromosome 14q, which contains several target genes that have been implicated in asthma, including prostaglandin E receptor 2 (PTGER2), arginase II (ARG2), and alpha-1-antichymotrypsin precursor (AACT).131,132 Within asthmatic patients, those with the greater number of genetic alterations have higher mean immunoglobulin E and blood eosinophils,1 33 both of which are indicators of inflamma-tion and bronchial hyperre-sponsiveness. Analyses of COPD samples demonstrate that LOH occurs most frequently at the thyroid hormone receptor alpha-1 (THRA1) locus on chromosome 17q21. 1 34 It is believed that exposure to tobacco smoke is a risk factor for the genetic changes associated with COPD, and individuals with COPD (similar to those with IPF) carry a greater risk for the development of lung...

Peroxisome proliferatoractivator receptor gamma PPARg

Peroxisome proliferator-activated receptors (PPARs) are orphan receptors belonging to the steroids thyroid retinoid receptor super family of ligand-activated transcription factors. There are three PPAR isoforms (PPARa, -p, -g), each of which is differentially expressed and displays a distinct pattern of ligand specificity 50 . PPARs are implicated in several physiological processes, such as the regulation of lipoprotein, lipid metabolism and glucose homeostasis. Recent observations indicate that PPAR activators could reduce the inflammation induced in different inflammatory pathologies including asthma, hypertensive heart disease, hepatic inflammation and cerebral ischemia 51 . In vivo, PPARg agonists have been shown to modulate inflammatory responses in the brain and to reduce infract size following transient focal ischemia 52,53 . Cerebral ischemia is frequently accompanied by inflammation, which can worsen neuronal injury 54 . Activation of PPARg reduces inflammation and the...

Adipokines Inhibitory Yin and Stimulatory Yang Signals in Inflammation

Celsus's description (first century AD) of inflammation signs includes rubor et tumor cum calor et dolor. Inflammation is an essential biological response aiming at recovering from injury, wound healing being a paradigm of such a homeostatic phenomenon. However, what begins as a protective response becomes a damaging process in excess hence, inflammation is increasingly recognized as the underlying basis of a significant number of diseases. Recent studies based on a pangenomic approach in human subcutaneous WAT revealed that a panel of inflammatory molecules was upregulated in obese compared to lean subjects (ref. 12and references therein). Of note, a calorie-restriction diet improved the anti-inflammatory profile of obese subjects via increase of antiinflammatory and decrease of proinflammatory molecules (12). Further, weight loss resulted in decrease of adipose macrophage number and an increased production of interleukin (IL)-10, a well-known anti-inflammatory cytokine (13). These...

George N Chaldakov Anton B Tonchev Nese Tuncel Pepa Atanassova and Luigi Aloe

Recently, the endocrine activity of adipose tissue cells has been intensively studied. In effect, a wide range of exported secretory proteins, dubbed adipokines, have been identified as constituents of the adipose proteome (adipokinome). Besides their effects on glucose and energy metabolism, adipokines are potent modulators of inflammation. This chapter provides a state-of-the-science review of adipokine-mediated paracrine signaling that may be implicated in the pathogenesis of inflammation-related diseases such as atherosclerosis, thyroid-associated ophthalmopathy, and breast cancer. We also point out a possible contribution of adipose tissue-associated mast cell secretory activity to the development of these diseases. Finally, we provide arguments for yin-yang (protective vs pathogenic) roles of adipokines in inflammation. This hypothesis may provide further novel drug targets for the development of adipopharmacology of inflammatory diseases. This chapter reviews data of adipose...

What is the next step after examination of the oral cavity

After examination of the oral cavity is completed, attention is directed at the size of the mandible and quality of TMJ function. A short mandible (shorter than three fingerbreadths) as measured from the mental process to the prominence of the thyroid cartilage (thyromental distance) suggests difficulty in visualizing the larynx. Patients with TMJ dysfunction may have asymmetry or limitations in opening the mouth and popping or clicking. Manipulation of the jaw in preparation for laryngoscopy may worsen symptoms after surgery. Curiously some patients with TMJ dysfunction have greater difficulty opening the mouth after anesthetic induction and neuromuscular paralysis than when they are awake and cooperative.

What factors may influence MAC

The highest MACs are found in infants at 6 to 12 months of age and decrease with both increasing age and prematurity. For every Celsius degree drop in body temperature, MAC decreases approximately 2 to 5 . Hyponatremia, opioids, barbiturates, a2-blockers, calcium channel blockers, acute alcohol intoxication, and pregnancy decrease MAC. Hyperthermia, chronic alcoholism, and central nervous system (CNS) stimulants (cocaine) increase MAC. Factors that do not affect MAC include hypocarbia, hypercarbia, gender, thyroid function, and hyperkalemia. MAC is additive. For example, nitrous oxide potentiates the effects of volatile anesthetics.

Constitutive Gpcr Activation Disease And Inverse Agonist Utility

A somewhat similar situation is seen with the related human thyroid stimulating hormone receptor (TSHR) system. Both sporadic and familial non-autoimmune hyperthyroidism are quite rare in occurrence, though in the past few years several examples of constitutive TSHR activation have been identified to account for at least some cases of familial and sporadic hyperthyroidism. It is important in these studies to rule out autoimmunity, as this is generally responsible for Grave's disease, a situation where autoantibodies have been shown to act as agonists of the TSHR. Moreover, transient disease can be caused by the passage of such antibodies from the milk of mother to child. Persistent hyperthyroidism in non-autoimmune patients is one of the key findings that points to a possible TSHR mutation. The age of onset in such disorders is variable and not fully explained at present. As with LH in the Leydig cell, the Gas- and Gaq-coupled TSHR stimulates thyroid hormone production and thyroid...

Transcriptional Activity Dimerization And Dna Binding

Dimerization is essential for the function of PPARs (Fig. 2). It has been demonstrated in vitro that PPARs form heterodimers with RXRs and that activation of PPARs can be increased in vitro by the addition of the RXR ligand, 9-cis-retinoic acid (59-63). As for other members of the nuclear hormone receptor family, PPARs regulate gene expression by binding to specific peroxisome proliferator response elements (PPRE) in the promoter regions of target genes (64) (Fig. 2). PPARs recognize a hormone response element that comprises a direct repeat (DR) of the hexameric AGGTCA half-site motif, with a one nucleotide spacer between the half elements (DR-1). The complex formed in vitro on such a response element is a PPAR -RXR heterodimer (59 -63). The first PPRE characterized was found in the promoter of the acyl-coenzyme A (CoA) oxidase gene and was defined as DR-1 (2). Further, it has been shown that PPARs can achieve gene tissue specific activity by being selectively bound as heterodimers to...

Which bones am I more likely to break

For all women with or without osteoporosis who are 50 years or older, the lifetime risk of fracturing any bone is about 40 , though most fractures occurring after age 50 are related to osteoporosis. For all U.S. adults, the lifetime risk of fracturing a bone is greater than the combined risk of developing breast, uterine, or ovarian cancers. If you are a woman, the risk of fracturing your hip, your spine, or your wrist is between 15 and 18 each. If you are a white elderly woman who either has hyperthyroidism (overactive thyroid), cannot get out of a chair without using your arms, or has a resting pulse rate of over 80 beats per minute, the risk for fracturing your hip is about 70 . If your only risk factor is that your mother broke her hip, then your risk is about 80 . But it's only about 50 if you fractured any of your bones since the age of 50. Even without any of these specific risk factors, age increases your risk for fracture by about 40 every 5 years. Your risk for hip fracture...

Rxr Modulators

RXR heterodimers with PPAR, LXR and FXR are known to activate gene transcription in the presence of an agonist for either of the partnered receptors and the diverse biological sequelae of RXR activation has been described in detail 105 . This summary will therefore focus upon the potential for antidiabetic effects of selective RXR agonists modulators that have recently been reported. RXR agonists such as LG100268, based upon the rexinoid scaffold, have been shown to be insulin-sensitizing agents. Unfortunately, these compounds also cause undesirable side effects (dramatic increase in plasma TGs and suppression of the thyroid hormone axis) 106 . Recently reported were a series of new RXR modulators that selectively activate the RXR PPAR heterodimer, but do not activate either RXR RAR (retinoic acid receptor) or RXR LXR 107 . Compound 44 afforded reductions in plasma glucose comparable to that of rosiglitazone in db db mice but has distinct off-target activity relative to that of...


High-throughput screen of a diverse collection of small molecules using F508del CFTR-NIH 3T3 cells resulted in the identification of CFTR potentiator 1 16 . Compound 1 displayed a measured EC50 of 2.4 jmM. Patch-clamp experiments recorded in temperature-corrected F508del-CFTR in NIH 3T3 cells indicated that 20 jmM of 1 increased the open probability of the channel and restored the gating of mutant CFTR to wild-type levels. In addition, 1 potentiated the defective gating of G551D-CFTR mutations expressed in FRT (Fisher rat thyroid) cells with a measured EC50 of 20 jmM. To confirm the activity of 1 in HBE cells isolated from CF F508del homozygous donor patients, in vitro pharmacology experiments were carried out. In CF-HBE, the cells were corrected with 15 (see Section 3) for 48 h prior to the acute addition of 1. Under these experimental conditions, 1 displayed an EC50 of 2.7 jmM, which is similar to that obtained in NIH 3T3 cells.

Future Directions

Fifth, certain kallikreins, such as human kallikrein 6, are highly expressed in the central nervous system. It has previously been shown that hK6, and possibly some other kallikreins, are implicated in inflammatory reactions within the central nervous system that lead to demyelination. The association of hK6 and some other kallikreins with AD and multiple sclerosis points to the possibility that some of these enzymes may play important roles within the central nervous system. In addition, many of these enzymes have been found in endocrine tissues such as the islets of Langerhans, thyroid, pituitary, and others, pointing to the possibility that they may participate in prohormone or hormone processing.

Their Hormones

Along with the pancreas, perhaps the most-recognized endocrine gland is the thyroid (THIGH-royd) gland. The thyroid gland literally ''resembles'' (-oid) two large, oblong ''shields'' (thyr) -as from a pair of African warriors pressing hands under the chin (Figure 10.3). The thyroid gland busily extracts the element iodine from the bloodstream, then incorporates it into its most important hormone, thyroxine (thigh-RAHKS-in). Thyroxine stimulates mitosis (cell division) and protein synthesis, thereby promoting body growth and tissue repair. It also tends to raise the BMR or Basal (BAY-sal) Metabolic Rate. The BMR (Basal Metabolic Rate) is the rate at which the body cells operate when they are under ''resting'' or ''basal'' conditions. In general, this means the times when we are neither exercising nor digesting any food. Thus, because it speeds up the metabolism, thyroxine tends to raise body temperature, as well. Endocrine gland (group) 5 The four...

Immune Privilege

The immune privilege site has been proposed to prevent reactivity in other tissues including the thyroid gland and pancreatic p-islet cells. Belgreu et al. 50 demonstrated that FasL expression by testicular Sertoli cells protected P-islet from rejection when transplanted heterotopically into the kidney capsule. Similarly, Griffith et al. 51, 52 , were able to prevent rejection of allogeneic pancreatic islet cells by cotransplantation with FasL positive myoblast which were also transplanted to the kidney capsule. These observations were presumably the result of induction of apoptotic cell death of Fas-positive cells invading the graft from the Fas-positive graft tissue. The implication of these studies is that manipulation of the Fas-FasL system might provide a mechanism to prevent local inflammation.

Other Ion Channels

Ion channels are presumably regulated in similar fashion to other membrane proteins, and may be subject to short-term biochemical regulation and channel sequestration and long-term down regulation as well as effects on mRNA levels and posttranslational processing (122,123). Ca2+ channels are subject to a number of regulatory influences (122). The numbers and function of voltage-gated Ca2+ channels are up-and down-regulated by chronic exposure to antagonist and activator drugs (122,124-126). They are altered by thyroid and estrogen treatment (127,128), they are up-regulated during chronic alcohol administration (129) and they are increased clinically in cardiomyopathy (130). Channel changes occur during disease states the lethal recessive absence of voltage-dependent Ca2+ channels in murine muscular dysgenesis is overcome by microinjection of an expression plasmid carrying DNA encoding the muscle 1,4-dihydropyridine receptor (131).

Endocrine System

Thyroid gland Thyroid gland Hypothalamus. The hypothalamus is the region of the brain that coordinates production and release of hormones by the pituitary gland, the thyroid gland, the adrenal glands, and the testicles. Thyroid gland. The thyroid gland produces the hormones thyroxine and triiodothyronine, which have an important role in metabolism (the chemical processes that take place in your body), and calcitonin, which helps regulate the calcium level in your blood and helps your bones retain calcium.

Adverse Effects

Other less frequent adverse effects include enlargement of salivary gland, enlarged thyroid gland without hyperthyroidism, oral ulcer, toothache, and gingival or nose bleeding. These side effects could disappear with symptomatic treatment, and the withdrawal of the drug is of no necessity during remission induction.

Hair Loss

A high fever or severe infection can produce hair loss, as can an overactive or underactive thyroid gland. Other causes of hair loss include an inadequate amount of protein in your diet, iron deficiency, or cancer treatment. Certain prescription medications such as those for gout, arthritis, depression, heart disease, or high blood pressure can cause hair loss in some people. Large doses of vitamin A also can cause hair loss. If you notice that your hair is falling out in large amounts after you brush or comb your hair, see your doctor as soon as possible to determine the cause.

Receptor Action

Retinoid receptors, like thyroid hormone receptors, vitamin D receptors, and steroid receptors, are classified as nuclear receptors (12). There are two classes of nuclear retinoid receptors RARs and retinoid X receptor (RXRs) (12). Each class of receptors consist of three subtypes alpha, beta, and gamma, and in vivo, these receptors exist as dimers (12,13). RXRs can dimerize with RAR, thyroid hormone receptors, and vitamin D receptors. RARs, however, can only dimerize with RXR

Side Effects

Effects of thalidomide on the endocrine system have been consistently observed in both clinical trials and animal experiments. These actions may be the result of an effect of the drug on the hypothalamus (82). In humans, a tendency to normalize hyperthyroid states has been noted. Iodine uptake by the thyroid gland was slightly decreased, and myxedema was occasionally observed. Increased urinary secretion of 17-hydroxycorti-costeroids associated with hypoglycemia has been reported. Thalidomide was found to antagonize the action of histamine, serotonin, acetylcholine, and prostaglandins in organ bath experiments, but had no influence on the uterine reaction to oxytocin, vasopressin, and histamine (82).


Pictures Upper Eyelid Surgery Sutures

Excessive reading, PC work, watching TV, working under neon-light illumination, and hereditary factors play a role in this process. The eyelids can reveal changes associated with disorders of the kidneys, heart, and thyroid gland, or which become apparent from alcohol or drug abuse. The swollen eyes of someone with a psychosomatic disorder may reflect un-cried tears , originating from unexpressed emotions. An eyelid lift will therefore convey the impression of an altogether much fresher person.

Gamma Ray Imaging

Imaging can also detect the location of gamma-ray emitting radiotracers that accumulate in target sites in vivo, due to localized expression of a reporter gene product. In this regard, the administered radiotracer must be cleared from the normal tissue so specific accumulation can be detected over background radioactivity. To date, this approach has been applied to image the in vivo expression of four different reporter genes, namely hSSTr2 23-26 , TK 27-39 , the type 2 dopamine receptor (D2R) 35, 37, 40-42 , and the thyroid sodium iodide symporter gene 43 . The expression of hSSTr2 has been imaged with radiolabeled peptide ligands including mTc-P829 23 , 188 Re-P829 23 , 99mTc-P2045 24-26 , and mIn-octreotide 25 . Figure 4 presents images that compare two different 99mTc-labeled somatostatin analogs for imaging Ad-mediated expression of hSSTr2. reporters were imaged in xenograft tumors 23-28, 32, 34, 36-45 , liver 29, 34-37, 39 , and striatum 42 , In the majority of xenograft tumor...

Nuclear Receptors

Overall, there have been at least 48 nuclear receptors identified in the human genome. They are classified into type I or type II receptors according to their mechanism of action, or subdivided into seven subfamilies based on their amino acid sequence. The subfamilies include receptors for steroid hormones such as cortisol and receptors that are activated by nonsteroidal compounds such as retinoids, thyroid hormones, and vitamin D. Many of the nuclear receptors are still known as orphan receptors, because their in vivo ligands are not yet identified.


Tinnitus is caused by hearing loss or by spasms (involuntary muscle contractions) in the muscles of the neck or jaw. The hearing loss, which may not be noticeable, may result from a variety of diseases and conditions, including stiffening of the bones in the middle ear, allergies, high blood pressure, diabetes, a tumor, a thyroid condition, or head or neck injury. Certain medications such as anti-inflammatory drugs, antidepressants, aspirin, or antibiotics can trigger tinnitus. However, most cases of tinnitus result from damage to the sensory hair cells and the microscopic endings of the auditory nerve, which are in the inner ear. This damage is common in older people. In younger people the damage

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